Multi-Level Factors Associated with Social Participation among Stroke Survivors: China's Health and Retirement Longitudinal Study (2011-2015)

• Published in: International journal of environmental research and public health Vol. 16; no. 24; p. 5121
• Main Authors: Cai, Yi, Towne, Jr, Samuel D, Bickel, C Scott
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 15.12.2019; MDPI
• Subjects: Activities of daily living; Adults; Aged; China; Community participation; Comorbidity; Correlation analysis; Demographic variables; Demographics; Dependent variables; Depression; Disability; Education; Exercise; Families & family life; Female; Humans; Independent variables; Longitudinal Studies; Male; Middle age; Middle Aged; Older people; Participation; Physical fitness; Quality of life; Retirement; Social Behavior; Social factors; Social Participation; Sociodemographics; Stroke; Stroke - psychology; Survival; Survivors - psychology; Variables; China; community building; social participation; post-stroke
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph16245121

This study aims to examine the impact of individual-level and community-based factors on popular social participation activities of Chinese middle-aged and older adults post-stroke. Sub-samples of survivors of stroke (2011: n = 413, 2013: n = 395, 2015: n = 441) recruited by the China Health and Retirement Longitudinal Study (CHARLS) were included in the analysis. Zero-inflated Poisson and multi-level logistic regression models were used to explore factors associated with social participation. More than half of individuals (55.0%) had no social participation and 23.4% participated in multiple social activities. The most popular social activities that individuals participated in were interacting with friends (32.6%) and going to a community club to play table games (22.7%). Multiple individual-level factors were negatively related to social participation (e.g., depressive symptoms and multiple measures of functional limitations) while the allocation of an outdoor exercise facility in the community/village was positively associated with the participation of going to a community club to play table games. Stroke survivors are at high risk of limited social participation. Policymakers and other key stakeholders should consider community design among other potential solutions when identifying ways to link at-risk stroke survivors to both opportunities for rehabilitation (e.g., physical function) and social participation.