Objective: The purpose of this study was to characterise parents' concerns for their children's health behaviour and perceptions of motivators and barriers to positive child health behaviour change, and to determine associations between motivators and barriers and parents' priorities for a school-based healthy lifestyle programme. Design: Cross-sectional study of 46 parents who had completed an un-validated survey distributed during school-wide events. Setting: School for children aged 5-14 years in The Bronx, New York City, USA. Methods: Wilcoxon Rank Sum tests compared motivators and barriers to positive child health behaviour change by heath behaviour concern; Spearman's correlation assessed associations between motivators and barriers and programme priorities. Results: Parents concerned about child weight significantly ranked keeping up with others and decreasing clothing size as motivators, while parents concerned about child food choices significantly ranked improving food choices and decreasing body mass index (BMI) and clothing size as motivators. Food-, play-, and self-esteem-related motivators were associated with nutrition education (r[subscript s] [greater than or equal to] 0.41, p [less than or equal to] 0.01), physical activity classes (r[subscript s] [greater than or equal to] 0.29, p [less than or equal to] 0.04) and child involvement in programme decision-making (r[subscript s] [greater than or equal to] 0.43, p [less than or equal to] 0.01) priorities. Consistency-, child resistance- and home rules-related barriers were associated with nutrition education (rs [greater than or equal to] 0.37, p = 0.02), physical activity classes (r[subscript s] [greater than or equal to] 0.32, p = 0.02) and child involvement (r[subscript s] [greater than or equal to] 0.40, p [less than or equal to] 0.02) priorities. Conclusions: Despite the study sample size, selection bias, and generalisability limitations, prioritising nutrition, physical activity and child involvement in programme decision-making may enhance parent support for school-based healthy lifestyle programmes.