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

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.