The Socio-Ecological Factors of Physical Activity Participation in Infant and Toddlers with Disabilities

Background To effectively promote physical activity (PA) participation in infants and toddlers with disabilities (ITWD), a comprehensive understanding of the associated factors is necessary. Consequently, this study aims to examine the factors influencing PA participation in ITWD using the socio-ecological model. Methods The Disability Status Survey in South Korea has been used for the current study. ITWD aged below five years were selected, resulting in 5,825. Variables were selected across each level of the socio-ecological model: 1) Intrapersonal level (child's sex, chronic condition, disability level, perceived health), 2) Interpersonal level (siblings' status, grandparents' status, satisfaction with number of friends), 3) Organizational level (enrollment in physical therapy, enrollment in occupational therapy), 4) Environmental level (residential area, government support). The decision tree analysis was conducted using Chi-Square Automatic Interaction Detection to examine multi-level associated factors of PA participation in ITWD. Results The decision tree analysis produced a three-level model with six terminal nodes. In the study sample, 48.4% of participants reported participating in PA. The most common location for PA was at home, with balance exercises being the most frequent type of activity, followed by stretching. Frequent barriers to regular PA participation included a lack of professionals knowledgeable about disabilities and the absence of disability-specific programs. The decision tree analysis identified that not living with grandparents, having a sibling, and being enrolled in physical therapy were common predictors of PA participation in ITWD. Conclusions This study's strength lies in its thorough examination of the socio-ecological factors influencing PA participation in ITWD. The associated factors span both intrapersonal and interpersonal levels. To enhance PA participation among ITWD, interventions should target these levels.