Community participation, physical activity, and quality of life for children born very preterm.

Aim: To investigate the effects of community environment on physical activity and quality of life (QoL) and to describe the relationship between community participation with physical activity and QoL, in children born very preterm and at term.

Method: Participants in this cross-sectional study were 45 children aged 4 to 5 years old, born before 30 weeks' gestation and 89 term-born children. Measures were community participation (Young Children's Participation and Environment Measure; frequency, involvement, environmental helpfulness, environmental resources), QoL (Pediatric Quality of Life Inventory 4.0; PedsQL), and physical activity (7-day accelerometry). Effects of environmental helpfulness and resources on physical activity and QoL were estimated using g-computation. Relationships between participation frequency and involvement with physical activity and QoL were estimated using linear regression.

Results: Environmental helpfulness increased physical activity (average minute increase per percentage point environmental helpfulness score increase; 3, 95% confidence interval [CI] 0.1-7), reduced stationary time (-2, 95% CI -5 to -0.2) and improved QoL (average PedsQL social functioning score increase; 0.7, 95% CI 0.1-1.2). Greater community involvement was associated with better QoL (average PedsQL total score increase per unit involvement score increase; 5.8, 95% CI 0.7-10.9).

Interpretation: Improving environmental helpfulness may improve physical activity and QoL for 4- to 5-year-old children. Greater community involvement is associated with better QoL.