Unmet preferences for community arts participation and psychological wellbeing among older adults from five communities in Chengdu, China: a community-based cross-sectional study

Background Community arts may support healthy aging, but non-participation can reflect either low interest or barriers that prevent older adults from taking part in activities they already value. We examined unmet preferences for community arts participation and psychological wellbeing among older adults from five communities in Chengdu, China. Methods In this community-based cross-sectional study, five communities were enrolled through collaboration with neighborhood residents' committees, and residents were randomly selected from available community rosters. Unmet preference was defined as a survey-time mismatch in which participation in the principal preferred arts activity was below the participant's current desired frequency and the participant remained willing to increase participation if barriers were removed. Psychological wellbeing was assessed with the WHO-5 Wellbeing Index. The primary analysis used 30-imputation MICE linear regression with community fixed effects; a complete-case model was used as a sensitivity analysis. Results The final analysis dataset included 862 participants. Among 595 participants with a clear arts preference, 587 were classifiable for the primary comparison: 199 (33.9%) had unmet and 388 (66.1%) fulfilled preferences. Opportunity barriers accounted for 63.3% of primary barriers, capability barriers for 29.6%, and motivation barriers for 7.0%. In the fully adjusted MICE analysis, unmet preference was associated with a 5.16-point lower WHO-5 score (95% CI, −10.37 to 0.05; P = 0.051); the complete-case estimate was −4.61 points (95% CI, −10.15 to 0.93). Functional limitation was associated with a higher prevalence of unmet preference (adjusted PR, 1.40; 95% CI, 1.19 to 1.66), whereas low digital ability showed a positive but imprecise association (PR, 1.59; 95% CI, 0.98 to 2.58). Conclusions Unmet community-arts preferences were common; among participants with unmet preferences, reported barriers were predominantly opportunity- and capability-related rather than motivational. The association with lower psychological wellbeing was consistent across analyses but imprecisely estimated. Preference-responsive community arts provision, particularly for people facing functional or digital barriers, warrants evaluation in longitudinal and implementation studies.