{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:07:28Z","timestamp":1791353248356,"version":"4.3.1"},"reference-count":29,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2019,12,15]],"date-time":"2019-12-15T00:00:00Z","timestamp":1576368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: 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. Methods: 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. Results: 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. Conclusion: 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.<\/jats:p>","DOI":"10.3390\/ijerph16245121","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T05:19:38Z","timestamp":1576473578000},"page":"5121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Multi-Level Factors Associated with Social Participation among Stroke Survivors: China\u2019s Health and Retirement Longitudinal Study (2011\u20132015)"],"prefix":"10.3390","volume":"16","author":[{"given":"Yi","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Global Health, Wuhan University School of Health Sciences, 115 Donghu Road, Wuhan 430071, China"},{"name":"Wuhan University Global Health Institute, 8 Donghu south Road, Wuhan 430072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7310-5837","authenticated-orcid":false,"suffix":"Jr.","given":"Samuel D.","family":"Towne","sequence":"additional","affiliation":[{"name":"Department of Health Management &amp; Informatics, University of Central Florida, 4000 Central Florida Blvd, Orlando, FL 32816, USA"},{"name":"Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA"},{"name":"Department of Environmental and Occupational Health, School of Public Health, Texas A&amp;M University, College Station, TX 77843, USA"},{"name":"Southwest Rural Health Research Center, Texas A&amp;M University, College Station, TX 77843, USA"},{"name":"Center for Population Health and Aging, Texas A&amp;M University, College Station, TX 77843, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6897-5152","authenticated-orcid":false,"given":"C. Scott","family":"Bickel","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Samford University School of Health Professions, CHS Building 2 2159, 800 Lakeshore Drive, Birmingham, AL 35229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1212\/WNL.0000000000004056","article-title":"Rapid transitions in the epidemiology of stroke and its risk factors in China from 2002 and 2013","volume":"89","author":"Guan","year":"2017","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Yang, Y., Shi, Y.Z., Zhang, N., Wang, S., Ungvari, G.S., Ng, C.H., Wang, Y.L., Zhao, X.Q., Wang, Y.J., and Wang, C.X. (2016). The disability rate of 5-year post-stroke and its correlation factors: A national survey in China. 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