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• W2992180464 abstract "To describe leisure participation in adolescents with congenital heart defects (CHD) and identify factors associated with intensity of participation. Eighty adolescents with CHD were recruited (39 males, 41 females; mean age [SD] 15y 8mo [1y 8mo] range 11y 5mo–19y 11mo) of whom 78 completed the Children’s Assessment of Participation and Enjoyment (CAPE) outcome measure of leisure participation. The measure has five subscales: recreational, active-physical, social, skill-based, and self-improvement. Associations between the CAPE and age, sex, and development were examined. Motor ability (Movement Assessment Battery for Children, Second Edition), cognition (Leiter International Performance Scale-Revised), behavior (Strengths and Difficulties Questionnaire), and motivation (Dimensions of Mastery Questionnaire) were assessed. Participants exhibited impaired motor (43.5%), behavioral (23.7%), and cognitive (29.9%) development. The most intense participation was in social (mean [SD] 3.3 [0.99]) and recreational (2.9 [0.80]) activity types on the CAPE. Male sex (p<0.05) and younger age were associated with greater physical activity (<15y: 1.87; ≥15y: 1.31, p<0.05). Greater engagement in social activities was related to better cognition (r=0.28, p<0.05), higher motor function (r=0.30–0.36, p<0.01), and fewer behavioral difficulties (r=−0.32 to −0.47, p<0.01). Cognitive ability (r=0.27, p<0.05), dexterity and aiming/catching (r=0.27–0.33, p<0.05), and behavior problems (r=0.38–0.49, p=0.001) were correlated with physical activity participation. Persistence in tasks, an aspect of motivation, correlated with physical (r=0.45, p<0.001) and social activity involvement (r=0.28, p<0.05). Ongoing developmental impairments in adolescents with CHD are associated with decreased active-physical and social engagement, putting them at risk of poor physical and mental health. Health promotion strategies should be considered. Participación en actividades recreativas en adolescentes con cardiopatías congénitas Describir la participación en el tiempo libre en adolescentes con defectos cardíacos congénitos (CHD) e identificar los factores asociados con la intensidad de la participación. Ochenta adolescentes con CHD fueron reclutados (39 varones, 41 mujeres; edad media [DE] 15 años 8 meses [1 año 8 meses] rango 11 año 5 meses– 19 año 11 meses) de los cuales 78 completaron la medida de resultado de la Evaluación de la Participación y el Disfrute de los Niños (Children’s Assessment of Participation and Enjoyment [CAPE]) del ocio participación. La medida tiene cinco subescalas: recreación, actividad física, social, basada en habilidades y mejoría personal. Se examinaron las asociaciones entre el CAPE y la edad, el sexo y el desarrollo. Se evaluó la capacidad motora con la Batería de Evaluación de Movimiento para Niños (Movement Assessment Battery for Children, Segunda edición), la cognición (Leiter International Performance Scale-Revised), el comportamiento con el Cuestionario de Fortalezas y Dificultades (Strengths and Difficulties Questionnaire) y la motivación usando el cuestionario Dimensiones del Dominio (Dimensions of Mastery Questionnaire). Los participantes exhibieron problemas en el desarrollo motor (43.5%), conducta (23.7%) y en el desarrollo cognitivo (29.9%). La participación más intensa fue en los tipos de actividad social (media [DE] 3.3 [0.99]) y recreativa (2.9 [0.80]) en el CAPE. El sexo masculino (p <0.05) y la edad más joven se asociaron con una mayor actividad física (<15 años: 1.87; ≥15 años: 1.31, p <0.05). Una mayor participación en actividades sociales se relacionó con una mejor cognición (r = 0.28, p <0.05), una función motora más alta (r = 0.30–0.36, p <0.01) y menos dificultades en el comportamiento (r = –0.32 a –0.47, p < 0,01). La capacidad cognitiva (r = 0.27, p <0.05), la destreza manual y la habilidad para apuntar y atajar (r = 0.27–0.33, p <0.05) y los problemas de comportamiento (r = 0.38–0.49, p = 0.001) se correlacionaron con la participación en la actividad física. La capacidad de persistir en las tareas, un aspecto de la motivación se correlacionó con la participación física (r = 0.45, p <0.001) y la actividad social (r = 0.28, p <0.05). Los problemas de desarrollo en los adolescentes con CHD están asociados con una disminución de la participación física y social, lo que los pone a riesgo de una pobre salud física y mental. Deben buscarse estrategias para la promoción de la salud de esta población. Participação em atividades de lazer em adolescentes com defeitos cardíacos congênitos Descrever a participação em lazer de adolescentes com defeitos cardíacos congênitos (DCC) e identificar fatores associados com a intensidade de participação. Oitenta adolescentes com DCC foram recrutados (39 do sexo masculino, 41 do sexo feminino; média de idade [DP] 15a 8m [1a 8m] variação 11a 5m–19a 11m), dos quais 78 completaram a medida de participação em lazer Avaliação da participação e diversão das crianças (APDC). A medida tem cinco subescalas: recreacional, ativa-física, social, baseada em habilidades, e auto-aprimoramento. Associações entre a APDC e idade, sexo e desenvolvimento foram examinadas. A capacidade motora (Bateria de avaliação do movimento para crianças, segunda edição), cognição (Escala internacional de desempenho de Leiter- Revisada), comportamento (Questionário de capacidades e dificuldades), e motivação (Questionário de Dimensões do Domínio) foram avaliados. Os participantes exibiram comprometimento do desenvolvimento motor (43,5%), comportamental (23,7%), e cognitivo (29,9%). A participação mais intensa segundo a APDC foi nos tipos social (média [DP] 3,3 [0,99]) e recreacional (2.9 [0,80]). O sexo masculino (p<0,05) e menor idade foram associados com maior nível de atividade física (<15a: 1,87; ≥15a: 1,31, p<0,05). Um maior engajamento em atividades sociais foi relacionado com uma melhor cognição (r=0,28, p<0,05), maior função motora (r=0,30–0,36, p<0,01), e menos dificuldades comportamentais (r=–0,32 a –0,47, p<0,01). A capacidade cognitiva (r=0,27, p<0,05), destreza e mirar/apreender (r=0,27–0,33, p<0,05), e problemas comportamentais (r=0,38–0,49, p=0,001) foram correlacionadas com a participação em atividades físicas. A persistência nas tarefas, um aspecto da motivação, se correlacionou com o envolvimento em atividades físicas (r=0,45, p<0,001) e sociais (r=0,28, p<0,05). Alterações persistentes do desenvolvimento de adolescentes com DCC são associadas com engajamento ativo-físico e social reduzidos, o que os coloca em risco para sua saúde física e mental. Estratégias de promoção de saúde deveriam ser consideradas. This article's abstract has been translated into Spanish and Portuguese. Follow the links from the abstract to view the translations. Plain language summary: https://onlinelibrary.wiley.com/doi/10.1111/dmcn.15466 Engagement in active-physical, social, and other recreational activities begins in childhood, and high levels of involvement at this stage directly influence an individual’s participation profile in adulthood.1 Therefore, these health-promoting experiences need to be fostered early in life, particularly for those at risk of limited engagement.2 As with typically developing peers, participation in leisure activities for children and adolescents with disabilities has known health benefits, both physical and psychological.3, 4 Globally, children with developmental challenges have lower cardiovascular fitness and greater obesity. Pediatric societies, therefore, strongly endorse leisure participation in children and adolescents with chronic health conditions and disabilities.3, 5 There is now substantial evidence that children born with congenital heart defects (CHD) requiring early surgical repair have an elevated risk of long-term developmental disability, including impairments in gross and fine motor skills, executive functions, higher order speech production, behavior, and/or learning.6-9 The deleterious educational impact of these impairments at school is increasingly evident;10 however, the influence of developmental delays on participation in other life roles and activities remains unclear. With respect to leisure, several recent studies have focused specifically on physical activity. Findings to date would suggest that participation in physical activities is limited, even in those not medically restricted.4, 11-13 Consensus documents and practice guidelines emphasize that the majority of children with CHD have normal exercise tolerance and, therefore, physical activity should be strongly encouraged without restriction. They state that a small subset with residual diseases (e.g. aortic stenosis, hypertrophic cardiomyopathy, congenital anomalies of coronary arteries, ventricular dysfunction, and risk of arrhythmia) should avoid vigorous competitive or contact sports.4, 11, 14, 15 Nonetheless, the sedentary lifestyle that typifies many children with CHD may contribute to diminished exercise performance and, ultimately, to later health risks.4, 11, 14 Formal exercise interventions in adolescents with CHD results in improved physical activity, greater maximal exercise capacity and oxygen uptake, and less internalizing behaviors.16, 17 However, structured exercise training programs remain uncommon.11, 18 Of concern is the fact that parents’ perceptions of physical activity restrictions are often not aligned with cardiologists’ recommendations19 and parents may feel uncertain about which activities are appropriate for their child. Others have suggested that parents of children with CHD appear to be overprotective and more restrictive than necessary.11, 20 A qualitative study elucidated that adolescents with CHD may experience low self-efficacy, fear, and fatigue, thus limiting their participation in sports and other physical activities.21 Adolescents with CHD indicated that support from others and enhanced perceptions of mastery facilitated their participation.21 In order to guide health promotion strategies, the importance of adolescents’ preferences, mastery motivation, and diminished self-concept,22, 23 as determinants of participation in leisure activities requires clarification. Environmental factors such as social, peer, and family support should also be considered as potential determinants. Current practice approaches do not appear to influence the apparent sedentary lifestyles adopted by adolescents with CHD. There is a paucity of evidence on the involvement of adolescents with CHD in leisure activities beyond physical activities, which are, collectively, important for physical and psychosocial health, community integration, and well-being. Leisure activities include social (e.g. ‘hanging out’ with friends), recreational (e.g. arts, games), skill-based (e.g. gymnastics, swimming, or music lessons), and self-improvement (e.g. reading, chores) activities, in addition to physical activities and sports. This study aimed to characterize the level of participation in a wide range of leisure activities in adolescents with CHD. Factors associated with limited exposure to active-physical, social, and other recreational activities that are important to child health were explored, to better appreciate the barriers to participation. A regional sample of adolescents with CHD who required open-heart surgery at Montreal Children’s Hospital was recruited, once approval was obtained from the hospital’s research ethics board. We contacted participants recruited into our prospective study (born 1994–1998 and followed to school age)24, 25 currently living in the Montreal region and also recruited additional participants who met eligibility criteria (described below) from the hospital’s Cardiology Division. Once a parent and the adolescents provided written consent, we arranged evaluation at the hospital. A psychologist performed the Leiter International Performance Scale-Revised26 and Vineland Adaptive Behavior Scales, Second Edition survey form,27 to ascertain cognitive deficits and functional limitations. An occupational therapist completed the Children’s Assessment of Participation and Enjoyment (CAPE)28 and the Preferences for Activities of Children (PAC)28 with the adolescent (and a parent if needed), and performed the Movement Assessment for Children, Second Edition29 to assess motor ability. Adolescents completed the Self-Perception Profile,30 Dimensions of Mastery Questionnaires31 (motivation), and Social Support Scale for Children and Adolescents,32 with parental assistance when necessary. Parents completed the Strengths and Difficulties Questionnaire33 (behavior problems). The measures are described below. Demographic information was collected from parents by questionnaire. All evaluators were blinded to history and to each other's findings. Adolescents between 12 and 19 years of age with CHD, who as young children (<2y) were admitted either to the hospital’s neonatal intensive care unit or ward for surgical correction (open-heart surgery), were recruited. Those born at less than 37 weeks’ gestational age, or who had clinically documented perinatal asphyxia, blindness, deafness, genetic syndrome (associated with developmental delay), or brain malformation were excluded, as were adolescents and parents who could not speak or read English or French. Therefore, the sample of adolescents with a CHD represented those who had no known biological risk of disability beyond complications of their heart defect. The CAPE28 is a measure of involvement in voluntary leisure activities outside of school. A range of 15 formal activities (preplanned, structured) and 40 informal (spontaneous) activities were presented and questions about their intensity (how often) and level of enjoyment were scored using ordinal scaling. Mean scores for intensity (7-point: 1=one time in the past 4 months, 7=one time a day or more) and enjoyment (5-point: 1=not at all, 5=love it) were derived from items (i.e. consisting of numerous ordinal response questions) in each of the five subscales: recreational, active-physical, social, skill-based, and self-improvement/educational activities in the home and community; sums were treated as numerical and approximately normally distributed.28 Diversity scores represented the number of different activities the individual participated in per subscale. Higher scores on the CAPE indicate greater involvement and enjoyment of leisure activities in the five activity subscales. Test–retest reliability estimates for the CAPE range from interclass correlation coefficient (ICC) 0.67 to 0.86, and content and construct validity is supported.28 The PAC was also used to further characterize participation preferences. Participants classified each of the activities on the CAPE as those they would really like to do, sort of like to do, or preferred not to do at all. The PAC enabled us to determine whether the activities these adolescents most preferred were indeed the activities that they participated in. All measures selected have sound psychometric properties and are appropriate for use with our target population (Table S1, online supporting information).34 Children and adolescents with CHD are at risk of developmental difficulties, especially motor skills, cognitive abilities, and behavior, and these domains may influence participation in leisure activities. Standardized age appropriate measures for these areas were selected. The Movement Assessment Battery for Children, Second Edition29 assessed motor functioning across fine and gross motor tasks. The test items for adolescents assessed manual dexterity, ball skills, and static and dynamic balance. Scores between the 5th and 15th centiles are defined as clumsy or at-risk, and those less than the 5th centile are classified as a definite motor problem. The Leiter International Performance Scale-Revised, a norm-referenced, non-verbal measure with minimal motor response requirements provided a rapid estimate of global intellectual level.26 Behavioral difficulties were documented using the Strengths and Difficulties Questionnaire, a validated screening questionnaire of behavior in children and adolescents.33 In addition, functional limitations in everyday, meaningful activities were described using the Vineland Adaptive Behavior Scales, Second Edition, a discriminative norm-referenced measure of communication, daily living skills, socialization, and adaptive behavior in children.27 Using a semi-structured interview format, typical performance (what the child does do) was documented in relation to everyday demands and expectations. Intrinsic motivation is related to personal beliefs of how well an individual expects to perform an activity and how much he or she values that activity, and is closely linked with desire to engage in a particular task.35 Adolescent’s perceptions of their mastery motivation behaviors were measured using the Dimensions of Mastery Questionnaires31 as a possible determinant of leisure participation. A total persistence score (for object-oriented tasks, social activities with adults, social interactions with peers, gross motor tasks) was used in the analysis. Self-concept and self-worth were measured using total scores for the Self-Perception Profile for Adolescents (subdomains: scholastic and athletic competence, social acceptance, physical appearance, job competence, romantic appeal, behavior conduct, friendships [45 items]).30 Adolescent's age at assessment and sex were also considered as potential determinants of participation. Parents were asked to indicate total family income (categorical) and parents’ educational levels on a questionnaire as indicators of socio-economic status for purposes of describing our sample. Parent education was used as an independent variable in the analyses. Social relationships with other individuals and the extent to which they felt they were supported and in positive regard were measured using the Social Support Scale for Children and Adolescents.32 This instrument examined social support from four sources: parents, teachers, friends, and classmates (four subscales). There were six items in each of these subscales from which mean scores were then derived. Descriptive statistics were applied to characterize the sample in terms of intrinsic and extrinsic factors and participation in leisure activities. Differences in intensity of participation in leisure activities (CAPE, five subscales) between age categories (<15y or ≥15y), sex, and developmental categories (typical range vs impaired, using the cut-offs established by each of the measures) were tested using independent Student’s t-tests (p<0.05). Pearson’s rank correlation coefficient (continuous variables), Spearman’s (ordinal variables) and non-parametric Spearman’s rho correlations (categorical variables) were carried out to explore associations between the adolescents’ intrinsic and extrinsic characteristics and level of participation on the five leisure subscales. Finally, variables that were found to be associated in univariate analysis were tested in multiple linear regression models for intensity of participation in active-physical and social activities. Assumptions for normality, linearity, and homogeneity of variance for CAPE total scores within domains (subscale scores) were verified before running regression analyses. A maximum of seven or eight independent variables were entered per model (sample size convention of 10 participants/variable). Missing data were excluded from the analysis using listwise deletion, given that many independent variables were from parent- or self-report and not necessarily predictable based on the severity of impairment or other profile information (using imputation). The statistical significance threshold was set at p<0.05 for correlations and multiple regressions. The analyses were performed using SPSS software (IBM Corp., Armonk, NY, USA). Eighty adolescents (39 males, 41 females) were recruited at a mean (SD) age of 15 years 8 months (1y 8mo; range 11y 5mo–19y 11mo). Cyanotic heart lesions occurred in 64 out of 80 participants with 16 acyanotic; 22 with tetralogy of Fallot; 17 with transposition of the great vessels; eight with transposition and additional defects; nine with ventricular septal defect; eight with a univentricular heart; and less than five participants with all other defect types. Median age at first open-heart surgery was 1 year 1 month (range 0.1–23.8mo). Maternal education was high school or lower in 37.3% of cases. Combined annual income was under $40 000 in 18.0% and over $80 000 in 48.6%. Based on parental report, 35.2% of adolescents had a learning disability, 28.2% had a psychiatric condition, 26.8% had attention-deficit disorder. Over a third (36%) wore corrective lenses and 6.6% had hearing impairments. Developmental impairments were common, with 43.5% having motor deficiencies and 29.9% with an IQ <80. Behavioral difficulties were documented in 23.7% (total score borderline/abnormal); however, examination of subdomains highlighted a higher prevalence of difficulties for emotional symptoms (32.9%) and peer problem (38.1%) domains. Twenty-nine percent needed educational support and/or tutoring and 6.6% were in schools for children with special needs. Rehabilitation services were being utilized in 26.7%, most often as psychology services.10 Of 80 adolescents recruited, 78 completed the CAPE assessment. Overall, adolescents with CHD participated most in social and recreational activities, and less in the other activity types (Table 1). Results on the PAC indicate that adolescents most preferred social activities, followed by physical and recreational activities, and least preferred skill-based and self-improvement activities (Table 1). We hypothesized that socio-demographic factors (sex, age) and motor and cognitive impairments would differentiate the intensity of leisure participation. Results of group comparisons (e.g. male/female, with/without motor deficits) suggested that this was the case, specifically for sports and other physical activities. Adolescent males participated more frequently in active-physical activities compared to females (males: 1.75 [SD 0.94], females: 1.20 [0.89], p=0.012). Younger adolescents (<15y) were more engaged in physical activities (1.87 [SD 1.1] vs 1.31 [SD 0.87], p=0.035). Adolescents with motor challenges had lower intensity scores for physical activity participation (1.23 [0.95] vs 1.69 [0.97], p=0.042). Participants with low cognitive ability (IQ<80) engaged less frequently in active-physical activities (1.13 [0.73] vs 1.63 [1.04], p=0.021). For social activities, only adolescents with motor difficulties were less likely to engage in social leisure activities (3.06 [1.08] vs 3.45 [0.90], p=0.005); however, age, sex, and cognitive ability did not differentiate social participation patterns. Similarly, participation in recreational, skill-based, and self-improvement activities were similar across socio-demographic factors and developmental profiles. To further explore the association between child characteristics and intensity of participation in the five leisure activity types, correlations were carried out (Table 2). Intrinsic and extrinsic factors related most to the level of engagement in active-physical and social activities. Measures of development (motor, cognitive, behavioral) and adaptive functioning (Vineland Adaptive Behavior Scales, Second Edition subdomains) were uniformly correlated with physical activity level and social participation, as was self-perceived motivation levels, self-perceptions of athletic and social competence, and level of peer support. Overall, these developmental factors were not correlated with level of engagement in the other leisure activity types of recreational, skill-based, or self-improvement activities. The only exception was that total persistence (mastery motivation) was modestly associated with greater involvement in self-improvement activities (r=0.29, p<0.05). As with other populations at risk for low participation, the adolescents’ preference to participate in these leisure activities, as measured on the PAC, was moderately correlated with their actual participation in these five activity subscales, with correlations ranging from 0.34 to 0.48 (p<0.01). This modest correlation suggests that some activities that adolescents prefer (e.g. active-physical activities) are not the activities they actually participate in very often. Age was only significantly correlated with participation in recreational activities (−0.25, p<0.05), not active-physical and social activities. This mild negative correlation suggests that younger adolescents had a higher level of engagement in recreational activities than older adolescents. Sex was also correlated with recreational activities (r=0.51, p<0.01), such that male adolescents were more engaged in recreational activities. Type of heart lesion (cyanotic/acyanotic) was not associated with leisure participation across activity types. There were very few associations with three leisure activity types (skill-based, recreational activities, and self-improvement); however, there were multiple significant associations between child characteristics and active-physical and social activities. Multivariate linear regression analyses were carried out to include sex and independent variables that were correlated (r>0.30) with the active-physical (Table 3) and social activity (Table 4) subscales. The other three leisure subscales had few predictors on univariate analysis, therefore multivariate models were not tested. The strongest predictors of active-physical leisure activities were a high desire or preference for these type of activities as well as higher maternal education (less emotional symptoms, borderline significant). For social participation, preference for social activities emerged as the most important predictor with perceived social acceptance as borderline significant. A number of medical, developmental, and psychosocial sequelae are expected as children with CHD grow and develop after early surgical repair; therefore, these children require intermittent healthcare surveillance and services.15 Evidence suggests that early life habits can mediate later susceptibility to chronic health conditions in adulthood.36 Regular participation in sports and other physical activities was identified in a recent American Heart Association Scientific Statement as essential in preventing latent chronic health conditions in adulthood, such as hypertension, atherosclerosis, diabetes, and obesity.14 Of concern are adolescents who were exposed to perinatal biological stresses, have mild motor, behavioral, and/or cognitive deficits; they appear to adopt a more socially-deprived, sedentary lifestyle when compared to typically developing peers.11 Adolescents with CHD are often considered fragile, and overprotectiveness has been postulated to be associated with greater inactivity and consequent deconditioning.11 Our study focused on participation in a range of leisure activities in the community that are vitally important for children’s physical and mental health.1, 5 Adolescents with CHD are at risk for decreased engagement in active-physical activities; however, empirical evidence using quantitative measures are lacking. Furthermore, their participation in other leisure activities has not been described to date. This study provides quantitative evidence on leisure participation in adolescents with CHD and highlights that they are most engaged in social and recreational activities, which are less structured, but participate less in physical or skill-based activities. In terms of active-physical activities, adolescents who were less likely to be engaged were female, older adolescents, and those with motor or cognitive deficits. Furthermore, adolescents with motor difficulties were also less likely to participate in social activities with peers. Motivation levels, self-perception of athletic and social competence, and level of peer support all correlated with intensity of participation in physical and social activities. Participation was most strongly associated with the adolescents’ preference for the activity. Nonetheless, participation did not necessarily align with preferences; there was a high preference for engaging in physical activities but a lack of participation. These results align with findings from other adolescents with disabilities (e.g. cerebral palsy, juvenile rheumatoid arthritis) or at high-risk (e.g. survivor of preterm birth) for developmental impairments.37-39 Functional limitations and delays (motor, behavioral, cognitive) were frequently noted to be predictive of leisure participation in children and adolescents with physical disabilities. In children with CHD, there was an association between behavior problems and decreased physical activity, as estimated by parents.40 Therefore, developmental difficulties need to be considered as a possible barrier to engaging in particular leisure activities. Evidence in other high-risk groups (primarily with physical disabilities) also suggests that demographic factors influence involvement in leisure activities. Older age is associated with decreased participation and sex differences in leisure preferences (females: greater participation in skill-based and self-improvement; males: more involved in active-physical), mirroring the findings in this study.41 Indeed, sex and age have similar effects on typically developing peers.42 Our study demonstrates that self-perception and intrinsic motivation are associated with participation in physical and social activities that are both important for health and well-being. Mastery motivation (persistence in doing challenging tasks) linked to self-efficacy, was a key determinant of physical activity identified by children with CHD in a qualitative study.22 Self-concept may, therefore, be an important determinant, as low self-esteem may hamper confidence in confronting challenging leisure activities.43 Self-perception and motivation levels are potentially modifiable, and will depend on early exposure to a range of physical and social activities of interest, as well as encouragement and support in the engagement in these activities. Preference for activities is strongly associated with actual participation, as reported in other studies,37, 38 and should be capitalized on to foster greater engagement in physical activities. Social support from others was emphasized as a critical enabler to participation in other qualitative studies of adolescents with CHD21 and children with physical disabilities,41 and was empirically demonstrated in our study using standardized measures of peer support. Our findings suggest that higher maternal education was correlated with greater participation in physical activities, possibly because of greater interest in promoting their child’s participation and the financial resources to support organized activities and personal training. Families of children with complex CHD may use normalization as a coping strategy to limit concerns about their child’s delays. As a result, a subset may not seek out services to promote development.42 It is possible that parents of children with CHD may not place physical and other leisure activities as a health priority, given the other medical challenges they often face.21 Greater understanding of family attributes that possibly influence involvement in leisure activities is, therefore, needed. Limitations of this study are that this was a relatively small convenience sample of adolescents from one institution who had early open-heart surgery, and therefore the results may not be generalizable to all settings. The sample included adolescents with a variety of heart defects, and findings are not specific to one defect subtype. There was no information on the types of open-heart surgery that may influence outcomes. Finally, some measures are for adolescents up to 18 years of age, however we had some adolescents who were 19 years of age. Many factors associated with decreased engagement in physical, social, and other leisure activities are potentially modifiable. Environmental influences including social support and encouragement by teachers, peers, and family has been identified as helpful by adolescents with CHD for social experiences and physical activities.21 Pediatricians, cardiologists, and other medical specialists may also play an important role in encouraging involvement in sports, arts, social, and other leisure activities, beginning in early childhood. Individualized interventions, such as exercise training programs, may also be helpful,12, 44 particularly if followed up by enhanced integration into community-based physical activities, which will require targeted efforts. Many of these adolescents feel different from their peers, and this may possibly undermine full participation in community-based leisure activities.45 The desire by the adolescents to feel ‘normal’ may also need to be formally addressed to optimize engagement, but this requires further study.13 There may be an important role for rehabilitation services that apply an individualized approach46-48 and address perceived barriers to participation in activities that adolescents want to engage in. We acknowledge the tremendous efforts of our research assistants Anna Radzioch, Joey Waknin, Marie-Linda Boghdady, and Christopher Saunders. We also thank Sean Hatzigeorgiou for helping with recruitment and Dr Keiko Shikako-Thomas, Dr Marie Brossard Racine, Shira Vasilevsky, Melissa Turner, Rena Birnbaum, Marie-Elaine Lafrance, Corinne Mercier, Rochelle Rein, Nathalie Bilodeau, Anna Radzioch, and Dr Catherine Zygmuntowicz for carrying out the standardized assessments. We are especially grateful to the adolescents and families for their participation in this study. This paper was presented in part at the American Academy of Cerebral Palsy and Developmental Medicine, Austin, Texas, October 2015. This project was funded by the Canadian Institutes of Health Research (MOP-102720). This work was supported by infrastructure from the Montreal Children’s Hospital-Research Institute and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, both of which are funded by the FRQS. The authors have stated that they had no interests that might be perceived as posing a conflict or bias. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article." @default.
• W2992180464 created "2019-12-13" @default.
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• W2992180464 date "2019-12-03" @default.
• W2992180464 modified "2023-09-27" @default.
• W2992180464 title "Participation in leisure activities in adolescents with congenital heart defects" @default.
• W2992180464 cites W1510243169 @default.
• W2992180464 cites W1600133009 @default.
• W2992180464 cites W1885124733 @default.
• W2992180464 cites W1949251603 @default.
• W2992180464 cites W1964516062 @default.
• W2992180464 cites W1970080395 @default.
• W2992180464 cites W1972592550 @default.
• W2992180464 cites W1991858178 @default.
• W2992180464 cites W2009445916 @default.
• W2992180464 cites W2012392516 @default.
• W2992180464 cites W2016288913 @default.
• W2992180464 cites W2025802167 @default.
• W2992180464 cites W2026918575 @default.
• W2992180464 cites W2029337957 @default.
• W2992180464 cites W2038883426 @default.
• W2992180464 cites W2040551145 @default.
• W2992180464 cites W2054027151 @default.
• W2992180464 cites W2055269914 @default.
• W2992180464 cites W2060674212 @default.
• W2992180464 cites W2087228403 @default.
• W2992180464 cites W2094790158 @default.
• W2992180464 cites W2095784570 @default.
• W2992180464 cites W2096039551 @default.
• W2992180464 cites W2103194900 @default.
• W2992180464 cites W2114949397 @default.
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