Adapting and Implementing the “Helping Our Toddlers, Developing Our Children’s Skills (HOT DOCS)” Parent Training Program in an Australian Context: A Feasibility Study

ABSTRACT

Externalizing behavior problems are the most common mental health concern of early childhood, but only a minority of families access parent management training (PMT) programs that are empirically-supported for reducing and preventing these behaviors. This study aimed to evaluate the acceptability and preliminary efficacy of a group-based universal PMT program developed in the United States (US) and adapted for Australia. The program was “Helping Our Toddlers, Developing Our Children’s Skills” (HOT DOCS), designed to teach parents a personalized problem-solving approach to address their young children’s challenging behaviors. This paper describes the four-stage adaptation and implementation process and presents results from a feasibility study with pre-intervention, post-intervention, and 2-month follow-up data. Participants were 40 parents of 36 children (M age = 2.85 years). Retention in the program (92.5%) and attendance (M = 6.16 of 7 total sessions, SD = 1.09) were high, and parents reported using the recommended parenting strategies multiple times per week throughout the program (M = 3.31 to 5.57 times per week, SD = 1.86 to 2.03). Parent satisfaction with the program was high; feedback from participants suggested that acceptability could be improved by including Australian video examples. At post-intervention, parents reported significant improvements in parenting knowledge, parenting self-efficacy and parenting stress (Cohen’s d = 1.02 to 1.28), and parent reports of child behavior indicated significant improvements in challenging behaviors (d = 0.49 to 0.64), with all effects maintained at 2 months. These preliminary results suggest that the Australian adaptation of HOT DOCS should continue to be implemented and further investigated, with modifications to video examples to increase relevance for culturally-diverse Australian families.

KEYWORDS:

• Parent management training
• universal intervention
• externalizing behaviors
• adaptation
• dissemination
• implementation

Disclosure statement

No financial interest or benefit has arisen from the direct application of this research.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Notes

¹ Differences in feasibility and efficacy outcomes between families with children with clinically significant behavior problems at pre-intervention (n = 9) and families with children without clinically significant child behavior problems (n = 23) were explored with post-hoc t-test analyses. Among program completers, there were no significant differences between groups in program attendance, adherence, or program satisfaction. There were also no significant differences in efficacy outcomes of changes in HOT DOCS knowledge, parenting self-efficacy, or parenting stress (see Supplementary Table 1).