Characteristics of Inclusive Online Leisure Activities for Children With Disabilities: Qualitative Study (Preprint)

BACKGROUND Participation of children with disabilities in leisure activities is a key determinant of their physical and mental health. The COVID-19 pandemic has limited participation in leisure activities for all children, in particular, for children with disabilities. As a result, children with disabilities may be less active while feeling more isolated and stressed. Online communities and activities are taking on growing importance. Understanding how online activities include or exclude children with disabilities can contribute to developing inclusive communities that may support participation post-pandemic. OBJECTIVE The objective of this study was to identify factors that may facilitate or prevent the participation of children with disabilities in online leisure activities. METHODS We adopted a qualitative descriptive interpretative methodology and conducted interviews with two groups of participants: 1. service providers offering inclusive online leisure activities, 2. parents of children with disabilities who have engaged in online leisure activities during the COVID-19 pandemic. A semi-structured interview format was created based on the Theoretical Domains Framework (TDF). The questions focused on the description of the online activities offered by the service provider (e.g., age range, frequency, cost, target population, type of activity offered) and any adaptations to make the online activity accessible to children and youth with disabilities, as well as their perceptions and beliefs about what supported or deterred participation in the activities. RESULTS Seventeen participants described their experiences in participating and creating online leisure programs and factors preventing or facilitating children’s participation in online activities. Environment/ and context factors included: accommodations, the format of activities and the online setting, stakeholder involvement, and materials and resources available. Activities that had flexible schedules, both recorded and live options for joining, and provided clear instructions and information were perceived as more accessible. Beliefs involved characteristics of the child and the family environment, as well as characteristics of the organizations providing the activity. Activity facilitators who were familiar with the online environment and knew the specific characteristics of the child facilitated participation. Engagement of community champions, and respect for child’s individual preferences were perceived as positive. Access to technology, funding and caregivers’ ability to facilitate child engagement were crucial factors that need to be considered when offering online programs. CONCLUSIONS Online environments can offer an accessible and safe option for leisure participation when public health conditions prevent children with disabilities from participating in in-person activities. However, in order to make online activities accessible for children with a variety of disabilities there needs to be a clear planning towards universal online accessibility that accounts for individual needs and collective approaches to online leisure. Future work should consider developing and testing guidelines for online accessibility and the equity and public policy and programming considerations in offering these activities for all children. CLINICALTRIAL