Parental perceptions of child weight status and the interplay of socio-demographic factors and children's BMI in South-Western Sydney: The growing healthy kids Survey, Australia.

Objective: This paper examined parents' perceptions of their children's weight status by key parental socio-demographic factors. Methods: We used the 2018 Growing Healthy Kids-Population Health Survey's data to analyse 1353 parents' perceptions of their child's weight status in Southwest Sydney. Generalised linear multinomial mixed models were used to determine the associations between socio-demographic and economic factors and parents' perceptions of their children's weight status. Results: About 23 % of healthy-weight children, 65 % of overweight children and 55 % of obese children were incorrectly perceived by parents. Father as the primary guardian (overweight: OR = 0.60, 95 % CI = 0.55-0.65; obese: OR = 0.46, 95 % CI = 0.43-0.50) and parents who completed ≤12 years of school education (overweight children: OR = 0.18, 95 % CI = 0.17-0.20; obese: children OR = 0.54, 95 % CI = 0.49-0.459) were less likely to perceive their overweight or obese children as overweight although they were overweight. Parents who lived in more disadvantaged areas were more likely to perceive their obese children as obese (OR = 1.65, 95 % CI = 1.46-1.86). Parents who lived in moderately disadvantaged areas (OR = 0.54, 95 % CI = 0.47-0.61) and parents who reported an annual household income between $52,000 and $ 103,999 were less likely to perceive their overweight children as overweight (OR = 0.72, 95 % CI = 0.65-0.80; $78,000-$103,999: OR = 0.74, 95 % CI = 0.66-0.82). Conclusion: Our findings suggest that public health interventions should involve fathers while educating families and children in most and moderately disadvantaged areas about healthy weight management. They should also integrate routine weight and height measurements at the population and clinical levels to help parents understand their child's weight status accurately.