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. 2025 Aug;34(8):2317-2328.
doi: 10.1007/s11136-025-03993-0. Epub 2025 May 23.

Factors influencing participation in home, school, and community settings by 6- to 9-year-old children born preterm: a qualitative descriptive study

Tiffany K Bradshaw  1   2 , James T D Gibbons  1   2   3 , Andrew C Wilson  1   3   4 , Amber Bates  1 , Shannon J Simpson  5   6 , Jenny Downs  2   7   4
Affiliations

Factors influencing participation in home, school, and community settings by 6- to 9-year-old children born preterm: a qualitative descriptive study

Tiffany K Bradshaw et al. Qual Life Res. 2025 Aug.

Abstract

Purpose: There is no published information on preterm children's activities and participation during middle childhood, a time when growth and development are characterised by increasing motor, reasoning, self-regulation, social and executive functioning skills. This study explored the health, activities and participation of children born very preterm during middle childhood (6-9 years) from the perspectives of their parents.

Methods: This was a qualitative descriptive design. Twenty parents of 27 very preterm children born < 32 weeks gestation participated in semi-structured interviews to explore their child's health, behaviour, functioning and participation in school, at home and in the community along with environment and personal factors that influenced the child's activities and participation. Interview data were coded to each of the International Classification of Functioning in Disability (ICF-CY) domains.

Results: Parents reported a broad range of health needs and participation outcomes. Parents reported challenges related to respiratory health, mental health and behaviour, sleep, nutrition and feeding. The child's participation and functioning were influenced by both personal and environmental factors including but not limited to parenting styles, education and learning support, access to health support and personal preferences and motivations.

Conclusion: Preterm birth is associated with impacts on the child's health, activities and participation. This comprehensive view on the child's health and wellbeing can aid clinicians in their management of these children.

Keywords: Development; Functioning; Middle Childhood; Participation; Preterm.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have no conflict of interest to disclose. Ethical approval: Ethical approval was obtained from the Child and Adolescent Health Services Human Research Ethics Committee (RGS5034).

Figures

Fig. 1
Fig. 1
Illustration of the health, personal and environmental factors that underpinned activities and participation in children who had been born very preterm
Fig. 2
Fig. 2
Word cloud presenting parent descriptions of their child’s greatest strengths and challenges. Larger words appeared more frequently in the source text
See this image and copyright information in PMC

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