Unlocking Happiness: Assessing the Monetary Value of Leisure Activities on Subjective Well-Being.

Improving the level of subjective well-being or happiness is often the primary goal for the government and its policy. Thus, knowing the value of leisure activities in improving the subjective well-being would hugely contribute to the policy-making process. This study explores the impact of participation in leisure activities on individual subjective happiness by applying the well-being valuation method to the national survey data collected in South Korea. Among the five leisure activities, participation in culture and arts, participation in sports, and tourism activities emerged as significant determinants of subjective happiness at the significant level of 0.05. At the individual level, participation in culture and arts exhibited the highest monetary value, while tourism activities have the highest monetary value at the national level, factoring in the total population and the participation rate across the country. These findings confirm the effect of leisure participation in improving subjective well-being and its corresponding monetary value and suggest that government should be appropriately utilizing the leisure policy to increase the frequency and type of leisure participation, thereby enhancing the level of happiness across the society. Results have significant implications for policy makers, practitioners, and academics in the domains of leisure and tourism.

The contribution of the smartphone use to reducing depressive symptoms of Chinese older adults: The mediating effect of social participation.

Background: Depression is a prevalent mental health disorder. Although Internet use has been associated with depression, there is limited data on the association between smartphone use and depressive symptoms. The present study aimed to investigate the relationship between smartphone use and depressive symptoms among older individuals in China. Methods: 5,244 Chinese older individuals over the age of 60 were selected as the sample from the China Longitudinal Aging Social Survey (CLASS) 2018 dataset. The dependent variable "depression symptoms" was measured using the 9-item Center for Epidemiologic Studies-Depression (CES-D) scale. The study employed multiple linear regression to investigate the relationship between smartphone use (independent variable) and depressive symptoms in older people. Thorough analyses of robustness, sensitivity, and heterogeneity were conducted to ensure the robustness and sensitivity of the findings. Additionally, mediating effect analysis was performed to elucidate the mechanism through which the dependent and independent variables were related. Results: Empirical study indicated that smartphone use had a negative impact on depressive symptoms among older adults, specifically leading to a reduction in such symptoms. The above-mentioned result was verified through endogenous and robustness tests. The heterogeneity analysis revealed that older individuals aged 70 years and above, male, and residing in urban areas exhibited a stronger association between smartphone use and depressive symptoms. Furthermore, the mediating effect model indicated that political participation, voluntary participation, and active leisure participation mediated the relationship between smartphone use and lower levels of depression symptoms among the older adults. However, passive leisure participation had a suppressing effect on the relationship between smartphone use and reduced depressive symptoms among the older adults. Limitations: The causal relationship between variables required further investigation with a longitudinal design. Conclusion: These findings suggested that smartphone use may be considered an intervention to reduce depression symptoms among older people by increasing levels of political participation, voluntary participation, and active leisure participation.

Leisure Participation and Cognitive Impairment Among Healthy Older Adults in China.

Leisure participation is beneficial to various health outcomes. This study examined a comprehensive list of leisure activities in relation to incidence of cognitive impairment among healthy older adults (65+) in China. Using data from the 2002 to 2018 Chinese Longitudinal Healthy Longevity Survey, we found that most of the leisure activities were protective of cognitive decline and three leisure activities (watching TV, doing housework, and playing cards/mah-jong) stood out as the most important ones. Additionally, our results revealed subgroup variations in the association between leisure participation and cognitive function: Leisure activities such as reading newspapers/books (not significant for the illiterate), gardening (not significant for the illiterate), and regular exercise (not significant for the rural residents) had different effects across different demographic social groups. Our findings suggest that intervention programs designed to prevent cognitive decline for older adults should consider subgroup and cultural variations in order to yield the best outcomes.

Systematic review of the psychometric properties of cultural adaptations and translations of the Children's Assessment of Participation and Enjoyment (CAPE).

BACKGROUND: The Children's Assessment of Participation and Enjoyment (CAPE) is the most widely used questionnaire for the assessment of children participation. While several cultural adaptations and translations exist, the quality of the methods used to produce them, as well as their psychometric properties, remains unclear. The aim of this systematic review was to evaluate the different translated and/or culturally adapted versions of the CAPE for children and youth with and without disabilities. METHOD: A search was performed in five electronic databases CINAHL (EBSCO), MEDLINE (OVID), EMBASE (ELSEVIER), PSYCINFO (OVID), and WEB OF SCIENCE Core Collection (CLARIVATE), for articles available in French or English with the last update in July 2022. All studies related to a cultural adaptation and/or translation of the CAPE were retained and evaluated based on established guidelines for cross-cultural adaptations and measurement properties. The extraction was done independently by two authors. A critical appraisal of translation and psychometric properties methods was performed. Critical appraisal of the articles was done using the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures tool and the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology. RESULTS: The search identified 642 studies (321 duplicates removed), 16 of which underwent full-text review. Nine studies met all inclusion criteria and underwent analysis. According to the recommended steps for cross-cultural adaptations, one study performed 100% of the steps and two others performed 80%. None of the studies met all the recommendations for the evaluation of psychometric properties. A full evaluation of reliability and internal consistency were reported by 74% of studies. None of the studies reported a full evaluation of responsiveness, agreement and/or construct validity. CONCLUSIONS: This review demonstrated limitations in the robustness of the methods used to develop and evaluate translated and culturally adapted versions of CAPE. To ensure valid and reliable results when conducting future research using the CAPE, it is recommended to fully evaluate the psychometric properties of the existing versions and to produce other translated and culturally adapted versions of the questionnaire.

Factors Associated With Participation in Physical Leisure Activities in Taiwanese Community-Dwelling Older Adults.

This study was to identify factors at the intrapersonal, interpersonal, and community levels that relate to physical leisure participation in Taiwanese community-dwelling older adults and to examine their relative importance. We used a cross-sectional study with purposive sampling (N = 160). Physical leisure participation was quantified as the variety, frequency, and duration of participation. Data were analyzed using a series of hierarchical multiple linear regressions. The results showed that higher variety, frequency, or duration of physical leisure participation was associated with older males and with those who reported having better health, fewer depressive symptoms, and greater social support. Intrapersonal- and interpersonal-level factors play a relatively more important role in predicting physical leisure participation than factors at the community level. Understanding factors that relate to these three levels of participation has the potential to inform interventions that are tailored to individual profiles.

Comprehensive Analysis of the Relationship Between Leisure Constraints Negotiation and Leisure Participation Within the Korean Context.

The purpose of this study was to identify relationship between leisure constraint negotiations and leisure activity participation through meta-analysis within the Korean context. Through this study, the inconsistent research results of previous studies are explained by comprehensively clarifying the relationship between the two variables and identifying a third variable that controls the relationship. The efforts of this project are expected to provide useful data that can be used for future research and to seek ways of increasing participation in leisure activities. In order to achieve the purpose of this study, the research questions set in this study are as follows. First, what is the magnitude of the effect of the correlation coefficient between leisure constraint negotiations and leisure participation? Second, what are the variables that control the relationship between leisure constraint negotiations and leisure participation? Materials were collected by utilizing Research Information Sharing Service, DBpia, Korean studies Information Service System, and Korea Citation Index. Finally, 20 pieces of research materials were selected with a total of 6,843 participants. The conclusions drawn from the research questions set in this study are as follows. First, leisure constraint negotiations and leisure participation are in a static relationship, and their level is considerable. In other words, efforts to overcome leisure constraints increase participation in leisure activities. Second, gender, age, and type of active leisure activities are major variables that control the relationship between leisure constraint negotiations and leisure participation. Finally, the limitation of this study and future research orientation were discussed.

Effects of Social Capital and Leisure Participation on Self-Rated Health of Urban Residents in Southwest China.

Background: Leisure provides opportunities for urban and rural residents to relax, recover their vitality, and improve their personal growth, development, and well-being. However, the impact of the leisure participation process, types, obstacles, participation motivation, and satisfaction on health is not very clear, especially the impact of leisure behavior on health, and is worthy of in-depth discussion. Objective: The objective of this study was to explore the impact of social capital and leisure participation on the self-rated health of urban residents in China so as to provide an important reference for national health promotion activities. Methods: the questionnaire on the relationship between social capital, leisure behavior, and self-rated health was compiled by ourselves. The residents participating in leisure and fitness in 25 residential fitness centers in Chengdu were investigated in the morning and evening, and the obtained data were processed by exploratory and confirmatory factor analysis. Results: (1) Social capital had no direct influence on leisure hindrance; leisure motivation and leisure participation had no direct influence on self-rated health. (2) Leisure satisfaction has a direct positive impact on self-rated health, while leisure hindrance has a significant negative impact on self-rated health. (3) Social capital has a direct positive impact on leisure satisfaction, and social capital has a direct positive impact on self-rated health. Leisure satisfaction plays an intermediary role in the path of social capital affecting self-rated health, and the intermediary force exceeds the direct impact of social capital on self-rated health. Conclusion: The effect of leisure satisfaction on self-rated health is higher than that of social capital, and it plays an intermediary role in the impact path of social capital on self-rated health. Therefore, how to make urban community residents with different backgrounds obtain leisure satisfaction through leisure activities is an important topic of national health promotion.

Sensory Processing as a Predictor of Leisure Participation in Early Adolescents.

Sensory processing may be associated with adolescents' preferences for different leisure activities. However, knowledge about how different sensory processing patterns may relate to adolescents' participation in leisure activities is scarce. This study sought to investigate the relationship between sensory processing and leisure participation in early adolescents. Study participants were typical early adolescents aged from 11 to 12 years (mean = 11.88 ± 0.33, n = 140). The Adolescent/Adult Sensory Profile (AASP) and Children's Assessment for Participation and Enjoyment (CAPE) were used to determine the participants' sensory processing abilities. Correlational and multiple regression methods were employed to analyze the relationship between sensory processing and leisure participation. There were significant positive relationships between sensory seeking and participation (r = 0.177-0.350, p = 0.000-0.037). There were also significant negative relationships between low registration, sensory sensitivity, and overall participation (r = -0.202, p = 0.017, r = -0.212, p = 0.012). We found that formal activities, skill-based activities, and self-improvement activities were the main distinguishing factors between sensory processing types. Results suggest that sensation seeking and sensory sensitivity from the AASP were predictive of leisure participation. This study provides evidence to inform practices regarding the association of sensory processing and leisure participation and supports the need for assessing sensory processing in early adolescents.

Can the Unified Theory of Acceptance and Use of Technology (UTAUT) Help Explain Subjective Well-Being in Senior Citizens due to Gateball Participation?

Promoting successful aging strategies through well-reasoned caregiving programs is, and should be, one of the main objectives of many government policies and their implementing agencies. Well-being has been considered an important indicator of successful aging. Leisure is a key life domain and a core ingredient for overall well-being. Yet, within well-being research, few studies have made the connection between leisure participation as accepted behavior and subjective well-being in senior citizens. This study proposed to examine the applicability of the Unified Theory of Acceptance and Use of Technology (UTAUT) in explaining senior citizens' decision-making processes in terms of leisure participation behavior and the effect of such behavioral engagement on subjective well-being. The respondents were senior citizens in Taiwan who played gateball and were aged 60 years or older. A total of 595 usable responses were obtained and used to answer the research question. The empirical results indicate that performance expectancy, social influence, and facilitating conditions are positively and significantly related to senior citizens' gateball participation behavior. In addition, gateball participation behavior had a positive and significant effect on respondents' subjective well-being. The results of this study not only extend the application of UTAUT in terms of participation behavior in leisure activities, but also can provide gateball associations and government entities a theoretical model for developing and promoting gateball programs which serve or involve the elderly, as well as helping older adults to pursue satisfactory levels of wellbeing.

Designing User-Centered Mobile Health Initiatives to Promote Healthy Behaviors for Children With Disabilities: Development and Usability Study.

BACKGROUND: The gap between research and its practical application in community settings limits its impact on public health. Closing this gap has the potential to improve the well-being of underserved groups, such as children with disabilities. Mobile health has the potential to improve access to community resources and support for underserved populations, thereby encouraging improved health behaviors. OBJECTIVE: In this feasibility pilot study, we describe the development of the mobile app Jooay. Jooay was developed in partnership with stakeholders to facilitate access to leisure and physical activity community programs for children and youth with disabilities. We also reflect on the lessons learned throughout the implementation process that are relevant for improving the health behaviors of children with disabilities. METHODS: We used a participatory action research approach to develop the app. We also administered a survey to current Jooay users and analyzed various app usage indicators to explore use patterns, user feedback, and preferences. Finally, we critically appraised the implementation process through a best practices for implementation research framework. RESULTS: We developed a product that responds to users' identified need to find information and follows accessibility and user-centered design standards. The analysis of usage data revealed that access to the Jooay app is concentrated in urban areas. Perceptions, attitudes, and information needs varied according to the type of user. The use of the mobile app changed over time, and usage decreased after the app was downloaded, indicating a need for the sustained engagement of app users. Users found value in the ability to identify activities that they would not otherwise know about. However, app use alone was not sufficient to improve participation. Although the app was developed based on users' active input in multiple iterations, we encountered challenges with survey recruitment and attrition, suggesting the need for more seamless and engaging means for collecting data within this population. CONCLUSIONS: Interactions between users and the app can sustain user engagement and behavior change. We will improve the app's next iterations by using the information gained from this study to conduct a larger study to assess the relationship among social and material deprivation, urban design, and access to inclusive and adaptive leisure programs. This study will inform the improvement of app listings to improve the use of Jooay by different user groups and promote health through mobile apps for marginalized groups.

The Influence of Leisure Activity Types and Involvement Levels on Leisure Benefits in Older Adults.

Purpose: To explore the types of leisure activities, the degree of activity involvement, and the relationship between leisure benefits in older adults in cities and towns in Northern Guangdong, China; to provide valuable references for formulating related policies on the leisure industry for relevant governing bodies and for gaining the optimal benefits for industry business people and leisure enthusiasts. Methods: After searching for a large amount of literature and expert consultations, a questionnaire on the leisure involvement and leisure benefits scale was constructed. The participants aged 60 years or older were recruited as the survey population. By using SPSS statistics 21.0, the raw and processed data in this study were analyzed and interpreted. Results: (1) The approach that the leisure involvement levels were divided into subjective and objective involvement levels to predict leisure benefits was more comprehensive and reliable than uni-level prediction. Among them, the overall leisure involvement level had a significant positive effect on the leisure benefits of leisure participants; the performance of the subjective involvement level to enhance the leisure benefits comprehensively surpassed the objective involvement level. (2) The effect of leisure involvement levels on leisure benefits was affected by the type of leisure, which was manifested as physiological and psychological leisure pleasure; the degree of leisure involvement had an inverted U-shaped relationship with its emotional leisure benefits. For individuals with physiological hedonistic leisure, the degree of leisure involvement had an inverted U-shaped relationship with its emotional, social, and self-realized leisure interests. (3) For individuals with psychological leisure, the degree of leisure involvement was positively U-shaped with its social and self-affirmed leisure benefits. However, this finding needs to be confirmed by further research. Conclusion: There are two types of linear and curvilinear relationships between the degree of leisure involvement and leisure benefits, which makes the connection between leisure involvement and leisure benefits deviate from the linearity in a particular situation and present an inverted U-shaped or positive U-shaped relationship, which shows, when the individuals are under- or over-volume leisure activities involvement, they will not create excellent leisure benefits.

Validity and reliability of the 'Leisure Participation Observation' among adults with intellectual disabilities: A pilot study.

BACKGROUND: Individuals with intellectual disabilities have decreased leisure participation, affecting their health and well-being. Existing measures of leisure participation are primarily based on self- or proxy reports. This study describes the initial validity and reliability of Leisure Participation Observation (LPO), developed for individuals with ID. METHOD: Two judge panels (N = 10 each) completed a table of specifications for content validity. Reliability of the LPO was established on 38 individuals with moderate ID 25-45 years old. RESULTS: This study established the content validity of the LPO. Additionally, weighted kappa showed moderate-high statistically significant inter-rater reliability (.667-.859, p < .01) and low-moderate, significant test-retest reliability, based on intraclass correlations (.226-.474, p < .05). Finally, results yielded moderate-high internal consistency (α = .74). CONCLUSIONS: The LPO shows promise as an observation tool for assessing leisure participation in the moderate ID population that may serve as the basis for developing intervention programmes.

Carving out space for collective action: a study on how girls respond to everyday stressors within leisure participation.

Purpose: Stress and achievement pressure constitute factors affecting young people's mental health, especially among girls. Leisure participation holds the potential to be a collective space where young people can respond to stressors together. This study explores how girls collectively construct responses to daily stressors within the context of leisure participation. Methods: Nine focus groups were conducted with 16 girls aged 14-21 who were active members in two sport organizations in northern Sweden. Data was collected by using participatory observations and photo-elicited focus group discussions. Results: Our findings from the inductive thematic analysis were interpreted by combining the stress process model with social practice theory, resulting in three subthemes or responses: sharing sites of responsibility, resisting norms related to (gendered) youth and focused distraction. The subthemes were abstracted into the central theme of trustful belonging as a resource for collective responses, representing what pre-conditions need to be in place to make the responses possible. Conclusion: Leisure participation is an important relational space for young people to respond to stressors by making use of everyday routines, and the agency these social practices hold. However, the effort needed to respond to these stressors brought additional pressure in terms of responsibilities, and achievements.

The Relationship Among Leisure Activities, Depression and Quality of Life in Community-Dwelling Elderly Koreans.

OBJECTIVES: This study aimed to identify the relationship among leisure activities, depression, and quality of life of community-dwelling elderly in Korea. METHODS: We assessed 100 community-dwelling older adults. Leisure participation and leisure exploration were assessed by using the leisure participation for the elderly. Depression was measured using the Korean version of the Short Form of Geriatric Depression Scale, and quality of life was assessed using EQ-5D. Statistical analysis was performed using the independent-sample t test, the chi-square test, Spearman correlation analysis, and multiple regression analysis. RESULTS: EQ-5D scores of the depression group were significantly higher (p < .01). Geriatric Depression Scale (GDS) and EQ-5D scores showed a significant correlation with leisure participation and leisure exploration. Furthermore, leisure satisfaction was a significant factor in depressive symptoms (ß = -.320, p < .01). There was a significant correlation between depression or quality of life and leisure activities corresponding to games, social activities, cultural activities, outings, and information and communication. CONCLUSION: This study showed that leisure participation and leisure exploration of the elderly were significantly related to depression and quality of life. Social, emotional, active, and productive activities were the leisure activities that positively affected depression and quality of life.

Effects of Leisure Participation on Life Satisfaction in Older Korean Adults: A Panel Analysis.

South Koreans' life expectancy has dramatically increased over the last four decades. However, the life satisfaction index of older Korean adults has been in the bottom third globally. The large majority of older Koreans spend most of the day watching television at home. However, concrete evidence regarding the effects of leisure involvement on older adults' quality of later life is scant. Only a few existing studies have examined the link via cross-sectional survey data. Thus, the purpose of this study was to investigate whether meaningful leisure participation outside the home in older age plays an essential role in improving life satisfaction. To achieve the research aim, nationally representative panel data from the Korea Employment Information Service were used for the data analysis. The results indicated that social and productive leisure participation in religious activity, social gatherings, and volunteering was significantly related to quality of life in older adults. Moreover, frequent participation in travel and cultural activities outside the home were positively related to life satisfaction. These findings suggest that participation in meaningful leisure activities is a critical factor contributing to subjective well-being and good mental health in older Korean adults and should be encouraged.

Leisure participation and satisfaction in autistic adults and neurotypical adults.

Leisure participation is important for well-being and has been attributed to improved quality of life for autistic individuals. Rigorous studies exploring the leisure participation of autistic adults are sparse. This study aimed to compare the type of leisure activity and frequency of participation between autistic adults and neurotypical adults as well as compare and identify factors associated with their leisure satisfaction. Data for 145 autistic and 104 neurotypical adults were obtained from time point one of the Australian Longitudinal Study of Adults with Autism. The primary outcome measure used was the Leisure Satisfaction Scale. Autistic adults were less satisfied with their leisure overall (mean = 3.29, standard deviation = 0.75) compared with neurotypical adults (mean = 3.69, standard deviation = 0.55). Multiple linear regression revealed being younger and reporting less depressive symptoms were significantly associated with higher leisure satisfaction in autistic but not neurotypical adults. Engagement in solitary leisure activities was comparable across participants, but socialising in person was predominated by neurotypical adults. Leisure activity preferences of autistic adults' and the frequency of their leisure participation are important factors for clinicians to understand when working with this population and tailoring well-being interventions.

"I do like the activities which I can do " Leisure participation experiences of children with movement impairments.

AIM: To explore in depth the leisure participation experiences of children with movement impairments. METHODS: We used Interpretative Phenomenological Analysis approach to interpret and understand the experiences of 22 children with movement impairments, aged between 6 and 12 years. Children expressed their views through flexible child-centred methods of data collection that allowed the children to draw, paint, use stickers, and demonstrate their leisure activities and equipment while communicating about their experiences. RESULTS: Children participated in leisure activities of their choice, and expressed positive experience of fun, challenge, independence and achievement. The choice of activities depended on a combination of the motor functioning of the individual child, inspiration and support from families, friends and health professionals, as well as the possibility of adaptations and availability of community programmes. At times children felt disappointed and avoided some activities due to associated negative experience such as injury, fear, non-inclusion and the difficulty they had experienced in adapting and performing certain activities. CONCLUSION: Families, therapists and community service providers such as disability organisations could enhance leisure participation experiences by suggesting and creating opportunities that could increase children's choices of leisure activities. Implications for rehabilitation Children's choice of activities, places and friends is important for positive experiences of fun, achievement, challenge, independence and motivation in leisure participation. Families and health professionals could assist children make appropriate choices for leisure activities that depends on factors such as motor abilities, adaptations and availability of activities in the community. In the community, widening the options for leisure activities such as non-competitive adaptive sports and indoor sports for children with variable levels of movement impairment could improve leisure participation experiences.

Comparing parent and child reports of health-related quality of life and their relationship with leisure participation in children and adolescents with Cerebral Palsy.

The aim of this study was to examine the level of agreement between reports of health-related quality of life (HR-QoL) obtained from children and adolescents with cerebral palsy (CP) and their parents. We also examined the relationships between child and parent perception of the different domains of HR-QoL and participation dimensions. Sixty-nine children and adolescents with CP and their parents separately completed parallel forms of the KIDSCREEN questionnaire. The Spanish version of the Children's Assessment of Participation and Enjoyment (CAPE) was completed by the child/adolescent. Concordance between the children's and the parents' HR-QoL scores was analyzed via Pearson and intraclass correlations. Differences in means were tested using paired Student's t-tests. Chi-square tests were using to assess the incidence of personal variables in the agreement and disagreement of children-parents' responses. The relationships between HR-QoL and leisure participation was confirmed with Pearson's correlation coefficients. Correlations between child and parent HR-QoL scores were small in 7 domains, medium in 2 and large in the Social Support & Peers domain. Children reported significantly better HR-QoL than their parents did. Participation was positively associated with specific domains of HR-QoL, but only weakly, and there were discrepancies between parent and child reports of HR-QoL. These findings provide interesting information about the importance of hearing the voices of children and adolescents with CP to promote HR-QoL and leisure participation.

Factors associated with IADL independence: implications for OT practice.

BACKGROUND: Globally, the population is aging. Instrumental activities of daily living (IADL) are an important component of independent function and impact the ability of older adults to age in place. Therefore, factors associated with IADL independence warrant further study. OBJECTIVE: To explore the association of age, depressive symptoms and leisure participation with IADL independence, and the relative importance of these three factors in predicting IADL independence. METHODS: A cross-sectional design using an existing data set was employed. Older adults age 60 and older (n = 98) who resided in senior housing or their own home/apartment were included in the study. A hierarchical multiple regression analysis was employed. RESULTS: The second model predicting IADL independence using age, depressive symptoms and level of leisure participation was significant (F(3,96) = 15.57, p < 0.001) and explained 31.00% of the variance in IADL independence compared to the first regression model, which included age alone (R2 adjusted = 18.00%). Age was the strongest of the three predictors, accounting for 11.40% of the variance in IADL independence. Depressive symptoms and participation in leisure activities were also significant predictors, their unique contributions being 7.30 and 4.30%, respectively. CONCLUSION AND SIGNIFICANCE: Age, depressive symptoms and leisure participation are all significant predictors of IADL independence among older adults. Therefore, according to our preliminary findings, leisure participation and non-pharmacological interventions for depressive symptoms warrant attention in practice in relation to IADL independence.

Child and environmental factors associated with leisure participation in adolescents born extremely preterm.

BACKGROUND: Developmental impairments persist among adolescents born extremely preterm, and these individuals are at an increased risk for chronic disease later in life. Participating in active and positive leisure activities may act as a buffer against negative outcomes, but involvement in active-physical and skill-based activities is low in youth born preterm. AIMS: To explore the child and environmental determinants of leisure participation among adolescents born extremely preterm. STUDY DESIGN: Cross-sectional study. SUBJECTS: Participants were recruited from the hospital's Neonatal Follow-Up Program and included 128 adolescents born preterm (mean gestational age: 26.5 weeks). OUTCOME MEASURES: Leisure participation was assessed using the Children's Assessment of Participation and Enjoyment. Potential determinants were assessed using standardized tests and questionnaires. Selected factors were entered into five separate multivariable regression models. RESULTS: Child and environmental factors contributed between 21% (skill-based) and 52% (active physical) of the adjusted variance for participation intensity. Lower gestational age was associated with greater participation in recreational activities. Male sex, higher maternal education and better motor competence were associated with involvement in active-physical activities. Being older and feeling socially accepted were associated with participation in social activities. Families oriented to hobbies and higher maternal education were associated with participation in skill-based activities. Preference was the strongest determinant of participation in all five leisure activities. CONCLUSIONS: Activities should be adapted to individual skill level, include family and peers, foster social acceptance and be driven by the adolescent's preferences. Although certain factors cannot be modified, they can be used to identify adolescents at risk for low participation.