Understanding the Accuracy of Parental Perceptions of Child Physical Activity: A Mixed Methods Analysis.

Background: Interventions to increase children's physical activity (PA) have achieved limited success. This may be attributed to inaccurate parental perceptions of their children's PA and a lack of recognition of a need to change activity levels.

Methods: Fifty-three parents participated in semistructured interviews to determine perceptions of child PA. Perceptions were compared with children's measured MVPA (classified as meeting or not meeting UK guidelines) to produce 3 categories: "accurate," "over-estimate," and "under-estimate." Deductive content analysis was performed to understand the accuracy of parental perceptions.

Results: All parents of children meeting the PA guidelines accurately perceived their child's PA; while the majority of parents whose child did not meet the guidelines overestimated their PA. Most parents were unconcerned about their child's PA level, viewing them as naturally active and willing to be active. Qualitative explanations for perceptions of insufficient activity included children having health problems and preferences for inactive pursuits, and parents having difficulty facilitating PA in poor weather and not always observing their child's PA level. Social comparisons also influenced parental perceptions.

Conclusions: Strategies to improve parental awareness of child PA are needed. Perceptions of child PA may be informed by child "busyness," being unaware of activity levels, and social comparisons.