Advances in Applied Sociology
2012. Vol.2, No.3, 187-195
Published Online September 2012 in SciRes (http://www.SciRP.org/journal/aasoci) http://dx.doi.org/10.4236/aasoci.2012.23025
Hands-On Parent Empowerment (HOPE) Project: Comparing
Implementation in Social Service Centres and Preschools
Cynthia Leung1, Sandra K. M. Tsang2, Suzanne Dean3
1Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
2Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
3School of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne, Australia
Received July 10th, 2012; revised August 15th, 2012; accepted August 22nd, 2012
This project examined the effectiveness and implementation of an early intervention program for children
from new immigrant families in Hong Kong in two delivery settings, preschools and social services cen-
tres. Participants included 141 new immigrant mothers with preschool children, from 13 preschools and
two social services centres. The preschool participants were randomized into an intervention group
(30-session HOPE program) and a comparison group (six-session program) at the preschool level, while
participants from the two social services centres attended the 30-session HOPE program. Results indi-
cated that the HOPE participants in preschools and social services centres reported lower post-interven-
tion child behavior problem scores than the comparison group. Preschool HOPE participants reported
higher post-intervention social support than the social services HOPE participants and comparison group
participants. Qualitative information from preschool principals and centre supervisors indicated different
dynamics within the two settings. Implications and suggestions for service delivery were discussed.
Keywords: Child Development; School Readiness; Early Intervention; Effective Intervention;
Preschoolers
Introduction
It is recognized that inappropriate parenting is one of the sig-
nificant determinants of child developmental problems such as
child behavior problems. Parent training for parents of young
children has the potential to prevent the occurrence of future
developmental problems such as behavior or conduct problems
(Barlow & Parons, 2005).
Though the effectiveness of parent training programs as an
early intervention strategy is well recognized, Shriver and Allen
(2008) point out that the context of delivery is an important
consideration in the delivery of parenting programs. Practitio-
ners need to be aware of contextual variables which might in-
fluence the effectiveness and integrity of the program. An un-
derstanding of these contextual variables can provide important
information to encourage participation and to enhance effec-
tiveness.
In a meta-analysis on the effectiveness of parenting programs,
it was concluded that offering training in the community might
reduce psychological and logistic barriers to attendance which
might influence outcome (Reyno & McGrath, 2006). In an
earlier study, Cunningham, Brenner and Boyle (1996) found
that economically-disadvantaged families were more likely to
complete parent training programs in community-based settings
than in clinic-based settings. Gross and Grady (2006) pointed
out that administrative support for parenting programs was
important and staff would need to be enthusiastic about the
program to encourage parents to attend. This would be more
likely to happen where the mission of the organization was the
same as that of the parent training program.
Non-profit making child/family services agencies are com-
mon community service providers providing parent training
(Kohl, Schurer, & Bellamy, 2010). Apart from child/family
services agencies, Gross and Grady (2006) claimed that pre-
schools offered the greatest potential for providing access to
parents. Preschools are likely to be good partners as their pri-
mary goal of promoting child development is consistent with
those of parent training programs as a form of early interven-
tion for child developmental problems. Staff will probably see
parent training as enhancing the goals of the preschool. Their
support and encouragement are vital for motivating parent par-
ticipation and attendance.
From the perspective of help-seeking behavior, knowledge/
awareness of available services and perceived accessibility of
service are important considerations (Leong & Lau, 2001). It is
probably easier for parents to gain knowledge of parent training
programs organized by/co-organized with preschools and it is
likely that they would consider such programs accessible.
On the other hand, compared with preschools where inten-
sive individual treatment protocols may not be viable (Shriver
& Allen, 2006), social services centres have the advantage of
individualized services for families who need more intensive
support, and they are in a better position to deal with other fam-
ily issues such as marital or financial problems. One disadvan-
tage of social service centre is that it may be seen as a place for
people with problems and there is a stigmatization effect
(Leong & Lau, 2001) which might adversely affect participa-
tion in the first place.
The Hong Kong Situation
In Hong Kong, parent training has become more popular
since the 1980s. They are mainly provided by the education,
social service and health sectors (Tsang & Leung, 2005).

C. LEUNG ET AL.
Within the health sector, services are mainly provided by nurses
or health professionals (Leung, Ip, Tso, & Leung, 2003). In
social services agencies, the training is usually conducted by
social workers (Tsang & Leung, 2005). Within government
funded/subsidized primary and secondary school settings, the
training may be provided by student guidance personnel, or
school social workers, and sometimes through outsource ser-
vice by social workers in social service agencies. However,
though the preschool attendance rate is close to 90% (Census
and Statistics Department, 2007a), provision of parent training
in preschools is often limited by resource constraints because
the Hong Kong government does not fund free preschool edu-
cation (Rao & Li, 2009).
Though there is information on the effectiveness of parent
training in the Hong Kong context, there is no Hong Kong data
as to whether the context of delivery might influence parent
participation or program effectiveness in early intervention
programs such as parent training programs. The present study
aimed to investigate the influence of context of delivery on the
effectiveness of the HOPE program. The effectiveness of the
HOPE program in a preschool setting has already been reported
(Leung, Tsang, & Dean, 2011). The current study made use of
additional unpublished data from the HOPE study to investigate
the influence of context of delivery on program effectiveness.
The HOPE program was designed as an early intervention pro-
gram for new immigrant parents from mainland China with
preschool children. It consisted of 30 weekly sessions on lan-
guage and reading, preschool concepts, and behavior manage-
ment techniques. The program details can be found in Leung,
Tsang, Dean, & Chow (2009).
As part of the design to evaluate the program, preschools
which were willing to participate were randomized into the
intervention arm (HOPE program) and comparison arm, with
the preschool as the unit of randomization to avoid feelings of
inequality amongst the parents should they be assigned to in-
tervention or control groups in the same school, or experimental
diffusion. Two social service centres expressed interest in the
HOPE program, after hearing about the program from the re-
searchers. As they were not able to recruit a sufficient number
of participants to randomize them into intervention and control
group within centres, all participants in these two centres were
offered the HOPE program. This situation offered the opportu-
nity to adopt a quasi-experimental design to compare the deli-
very and effectiveness of a parent training program between
preschools and social services centres, which are set up for
different purposes with different target groups. It is recognized
that this is post hoc data, but the information may provide in-
sight for early intervention strategies and services providers as
well as directions for future research.
Method
Participants
The participants included 141 Chinese new immigrant par-
ents fulfilling the inclusion and exclusion criteria. The inclusion
criteria required was at least one parent being a new Chinese
immigrant (immigrant from mainland China who has resided in
Hong Kong for less than seven years, which is the official defi-
nition of a new immigrant in Hong Kong); the parent and the
target child being normally resident in Hong Kong; and the
target child being between 3 and 5 years of age and attending
preschools in Hong Kong. The exclusion criteria included chil-
dren with major developmental problems, or parents with his-
tory of domestic violence, drug abuse, or mental illness. The
participants were recruited from 13 preschools in three districts
with highest numbers of new immigrant families from
mainland China with children aged five years or under (n =
120), and two social services centres (n = 21) from two other
districts. The participants from preschools were randomized
into intervention (IP) and comparison group (C). The randomi-
zation was at the preschool level and there were seven pre-
schools in the intervention group (n = 66), and six preschools (n
= 54) in the comparison group. All participants in the social
services centres (IS) were assigned to the intervention group.
The demographic characteristics of the participants are in Table
1.
Measures
Child Measures
Wechsler Preschool and Primary Scale of Intelligence-
revised edition (WPPSI-R) (Wechsler, 2000)—this is an indi-
vidually administered intelligence scale for children aged 3
years to 7 years 3 months. The Chinese version was published
in 2000.
The Peabody Picture Vocabulary Test Revised (Form L)
(PPVT-R; Dunn & Dunn, Taiwanese Version, 1994)—this
Chinese adaptation of the original American test is a nonverbal
test designed to evaluate the receptive knowledge of vocabulary
of children 3 to 12 years of age.
Parent Measures
Eyberg Child Behaviour Inventory (ECBI) (Eyberg & Ross,
1978)—this is a 36-item multidimensional measure of parental
perception of disruptive behaviour in children and incorporates
two scores, intensity score and problem score. The Chinese
version of the inventory has been validated by Leung, Chan,
Pang and Cheng (2003).
Parenting Stress Index (PSI) (Lam, 1999)—this is a 36-item
questionnaire on issues related to parenting stress. The Chinese
version of the scale has been validated by Lam (1999).
General Self Efficacy Scale (Schwarzer, 1993)—this scale
consists of 10 items on a sense of personal competence in effi-
ciently dealing with various stressful situations measured on a
4-point Likert scale ranging from “Not at all true” (1) to “Ex-
actly true” (4). A validated Chinese version is available (Zhang
& Schwarzer, 1995).
Duke-UNC Functional Social Support Questionnaire (Broad-
head, Gehlbach, de Gruy & Kaplan, 1988)—this is an 8-item
questionnaire on perceived social support in various areas. The
questionnaire has been translated into Chinese using back
translation. It has been used with Chinese immigrants in Hong
Kong (Leung et al., 2007) and the reliability (Cronbach’s Alpha)
was .84.
Demographic information—parents are requested to supply
basic demographic information.
Qualitative Data
Focus group discussion guides and semi-structured interview
guides were used for focus group discussions with participating
parents and individual interviews with preschool principals and
social services centre supervisors.
Intervention
The intervention arm participants (IP and IS) participated in
the HOPE program, a 30-session program. The sessions were
188

C. LEUNG ET AL.
Table 1.
Demographic characteristics of participants.
Preschool (IP)
(n = 66)
Social Services
Centres (IS) (n = 21) Comparison (C) (n = 54) Significance
Child age 4.64 (0.70) 4.37 (0.64) 4.58 (0.58) F(2,138) = 1.38, p = .256
Child length of residence in Hong Kong 3.90 (1.29) 3.63 (1.48) 3.82 (1.44) F(2,138) = 0.31, p = .738
Mother age 32.48 (3.79) 30.60 (3.69) 33.23 (5.24) F(2,135) = 2.60, p = .078
Mother length of residence in Hong Kong 2.92 (2.25) 3.08 (2.90) 3.28 (2.72) F(2,134) = 0.30, p = .744
Father age 38.77 (6.04) 39.45 (8.60) 40.73 (8.01) F(2,133) = 1.06, p = .348
Father length of residence in Hong Kong 27.43 (15.22) 31.05 (13.97) 30.12 (14.97) F(2,131) = 0.68, p = .509
Number of children 1.71 (0.65) 1.35 (0.49) 1.73 (0.60) F(2,135) = 3.16, p = .046
Child sex (boys) 33 (50.0%) 12 (57.1%) 25 (46.3%) χ2(2) = 0.72, p = .698
Family status: nuclear 48 (72.7%) 17 (81.0%) 29 (53.7%)
Family status: extended 15 (22.7%) 0 (0%) 22 (40.7%)
Family status: others 3 (4.5%) 0 (0%) 1 (1.9%)
χ2(6) = 12.56, p = .051
Marital status: married 63 (95.5%) 20 (95.2%) 52 (96.3%) χ2(4) = 3.35, p = .502
Mother education: 9 years or less1 46 (69.7%) 13 (61.9%) 32 (59.3%) χ2(2) = 0.87, p = .647
Father education: 9 years or less1 37 (56.1%) 7 (33.3%) 26 (48.1%) χ2(2) = 3.20, p = .202
Mother employed 2 (3.0%) 1 (4.8%) 0 (0%) χ2(2) = 1.91, p = .385
Father employed 52 (78.8%) 14 (66.6%) 33 (61.1%) χ2(2) = 1.98, p = .371
Household income HK$19,999 or below2 64 (97.0%) 19 (90.5%) 44 (81.5%) χ2(2) = 3.80, p = .149
On Social Security 7 (10.6%) 1 (4.8%) 6 (11.1%) χ2(2) = 0.71, p = .702
Note 1: The Hong Kong education system prescribes nine years’ compulsory education for all students; Note 2: The median domestic household income was
HK$17,250 (Census and Statistics Department, 2007b).
conducted weekly, with each session lasting for about two
hours. The program was conducted by three social workers,
with one taking up six groups (five IP and one IS), one taking
two IP groups, and one taking one IS group. A manual with
lecture script for each session, powerpoint slides, parent hand-
out and parent worksheets was available. Facilitators were
trained to adhere strictly to the manual in group delivery.
The participants in the control arm (comparison group) were
offered the preschool version of the Universal Parent Education
Program. This program was developed by the Education Bu-
reau of the Hong Kong SAR Government for the use of all
preschools as a universal parent training program. The program
consisted of six sessions on parents’ role, self-esteem, par-
ent-child communication, behavior management and child
learning. Each session lasted for about two hours and the ses-
sions were conducted over six months, with one session per
month. The program was conducted by a health professional
with training in parent education.
Procedures
Invitation letters were sent to all the preschools in the three
districts with highest number of Chinese immigrant families
with preschool children, inviting them to participate in a parent
training program. Upon their consent to participate, preschools
were allocated to either the intervention or comparison arm by
random assignment. Two social services centres in two other
districts were interested in the HOPE program and they re-
cruited participants through their own usual means such as
posters and leaflets, or invitation by social workers working in
the centres. All participants recruited in the two centres partici-
pated in the HOPE program.
Upon signing the consent forms, the parent participants were
requested to complete the parent measures prior to the com-
mencement of the program, and upon program completion. The
children of the participating parents were assessed on the child
measures prior to the commencement of the program, and upon
program completion by clinical psychologists or educational
psychologists, and educational psychologists-in-training, under
the supervision of clinical or educational psychologists. The
allocation of assessors to children was random, according to the
availability of the assessors during the scheduled times. Asses-
sors were blind to the group membership of the children they
assessed. All child assessment was conducted in Cantonese in

C. LEUNG ET AL.
preschools (IP and C groups) or service centres (IS group),
usually within one session, with breaks for children where nec-
essary.
At the completion of the program, focus groups were con-
ducted with parents and individual interviews were conducted
with preschool principals in the intervention arm, and the su-
pervisors of the social services centres. These focus groups and
individual interviews were conducted by two educational psy-
chologists-in-training as part of their course requirements. The
interviews and focus group discussions were transcribed verba-
tim by these two educational psychologists-in-training.
This study was approved by the ethics committee of The
Hong Kong Institute of Education, where the first author
worked at the commencement of the project.
Data Analysis
Repeated measures analysis of variance (ANOVA) was used
to analyse the data. The between subject variable was organiza-
tion (IP versus IS versus C) and the dependent variables were
child behavior and parenting measures, with two levels (pre-
intervention and post-intervention). The main result of interest
was the interaction effect (types of organization X measures).
Analysis was conducted for participants with available data on
the variables measured, and by intention-to-treat.
Results
The Sample
There was no significant difference between the three groups
in terms of parent completion of pre-intervention measures,
χ2(2) = 2.15, p = .342, post-intervention measures, χ2(2) = 4.77,
p = .092, and child completion of pre-intervention measures,
χ2(2) = 1.22, p = .543. There was a significant difference in
child completion of post-intervention measures, χ2(2) = 9.65, p
= .008. Fewer participants from the IS group completed the
post-intervention measures compared with the IP group and C
group. There was a marginally significant difference between
the three groups in terms of percentages of drop-out cases, χ2(2)
= 5.95, p = .051, with a higher percentage of drop-out cases in
the IS group. There was also a significant difference in median
attendance rate between the three groups (p < .001). The details
are in Table 2.
There were 37 drop-out cases where the participants indi-
cated explicitly that they could not continue with the program,
with 14 (21.2%) from the IP group, 13 (24.1%) from the C
group and 10 (47.6%) from the IS group. The flow of partici-
pants is in Figure 1. For the drop-out cases, the parents were
invited to complete the post-intervention questionnaires and the
children were invited for the post-intervention assessment. In
cases where the parents refused to complete the post-interven-
tion questionnaires or refused to allow their children to be as-
sessed at post-intervention, their pre-intervention scores were
used to substitute for their post-intervention scores in the inten-
tion-to-treat analysis.
There was no significant difference between the drop-out and
non-drop-out cases in terms of pre-intervention parent and child
measures or demographic variables, except mother employment
status, χ2(1) = 8.85, p = .003, and pre-intervention self-efficacy
scores, t(134) = 2.13, p = .035. Three mothers (8.8%) among
the drop-out cases were working while none of the mothers
who remained in the program were working. The drop-out par-
ticipants reported lower pre-intervention self-efficacy scores (M
= 22.56, SD = 5.68, 95%CIs [20.58, 24.54]) than those who
remained (M = 24.77, SD = 5.11, 95%CIs [23.77, 25.78]).
There was no significant difference between the three groups
in terms of pre-intervention measures and demographic variables,
except for number of children. Post hoc test (LSD) indicated that
the IS group families had fewer children than families in the
other two groups. As number of children was not significantly
correlated with any of the post-intervention child or parent meas-
ures, it was not considered as a confounding factor.
Pair-Wise Analysis
Parent Outcome Measures. In this section, the analysis was
based on participants with complete pre-intervention and
post-intervention data on respective parent outcome measures.
There was a significant difference for pre-intervention and
post-intervention measures, F(1,112) = 15.09, p < .001, partial
eta squared = .119, as well as a significant interaction effect
(type of organization X measure) for ECBI-intensity, F(2,112)
= 3.98, p = .021, partial eta squared = .066. There was a de-
crease in child behavior problems from pre-intervention to
post-intervention among the IP and IS groups, but not the C
group. Post hoc test (LSD) indicated that the three groups dif-
fered from one another in post-intervention ECBI-intensity
scores. For ECBI-problem, there was a significant difference
for pre-intervention and post- intervention measures, F(1,112)
= 35.63, p < .001, partial eta squared = .241, but the interaction
effect (type of organization X measure) was not significant,
F(2,112) = 1.61, p = .205, partial eta squared = .028. For social
Table 2.
Completion of outcome measures and program.
IP (n = 66) IS (n = 21) C (n = 54) Total (N = 141)
Complete pre-intervention parent measures 63 (95.5%) 20 (95.2%) 48 (88.9%) 131 (92.9%)
Complete post-intervention parent measures 60 (90.9%) 16 (76.2%) 42 (77.8%) 118 (83.7%)
Complete pre-intervention child measures 65 (98.5%) 21 (100%) 52 (96.3%) 138 (97.9%)
Complete post-intervention child measures 62 (93.9%) 15 (71.4%) 50 (92.6%) 127 (90.1%)
Remained in program 52 (78.8%) 11 (52.4%) 41 (75.9%) 104 (73.8%)
Median attendance 89.00% 46.00% 33.00% 83.00%
190

C. LEUNG ET AL.
IP group (n = 66)
(
7
p
reschools
)
Complete
pre-intervention data
Parent measure (n = 63)
Child measure (n = 65)
Complete
pre-intervention data
Parent measure (n = 48)
Child measure
(
n= 52
)
Remained in program
(n = 52)
Remained in program
(
n = 41
)
Complete
post-intervention data
Parent measure (n = 60)
Child measure (n = 62)
Complete
post-intervention data
Parent measure (n = 42)
Child measure (n = 50)
Dropped out from
program (n = 14)
Preschool withdrawal
(n = 6)
Found employment
(n = 6)
Child care problems
(n = 1)
Returned to China
(n = 1)
Dropped out from
program (n = 13)
Preschool withdrawal
(n = 8)
Found employment
(n = 2)
Child care problems
(n = 2)
Returned to China
(n = 1)
Recruited into the project (N = 141)
(13 preschools and 2 social services centres)
C group (n = 54)
(
6
p
reschools
)
IS group (n = 21)
(2 centres)
Complete
pre-intervention data
Parent measure (n = 20)
Child measure
(
n= 21
)
Dropped out from
program (n = 10)
Found employment
(n = 4)
Time clashes (n = 3)
Returned to China
(n = 1)
Health (n = 1)
Program unsuitable
(n = 1)
Remained in program
(n = 11)
Complete
post-intervention data
Parent measure (n = 16)
Child measure (n = 15)
Figure 1.
Flow of participants through each stage of the project.
support, there was a significant difference for pre-intervention
and post-intervention measures, F(1,110) = 8.26, p = .005, par-
tial eta squared = .070, and the interaction effect (type of or-
ganization X measure) was also significant, F(2,110) = 4.84, p
= .010, partial eta squared = .081. There was an increase in
social support in the IP group, but not in the IS group. Post hoc
(LSD) test indicated that the IP differed significantly from IS
and C groups. For PSI, there was a significant difference for
pre-intervention and post-intervention measures, F(1,110) =
23.08, p < .001, partial eta squared = .173, and the interaction
effect (type of organization X measure) was also significant,
F(2,110) = 3.14, p = .047, partial eta squared = .054. There was
a decrease in parenting stress from pre-intervention to
post-intervention for IP group but not so in the IS group. How-
ever, post hoc test did not indicate any differences between
groups. For self-efficacy, there was a significant difference for
pre-intervention and post-intervention measures, F(1,112) =
4.288, p = .041, partial eta squared = .037, but the interaction
effect (type of organization X measure) for self-efficacy was
not significant, F(2,112) = 0.55, p = .581, partial eta squared
= .010. The details are in Table 3.
Child Outcome Measures. In this section, the analysis was
based on participants with complete pre-intervention and post-
intervention data on respective child outcome measures. For
Verbal IQ, there was a significant difference from pre-inter-
vention to post-intervention, F(1,122) = 17.90, p < .001, partial
eta squared = .128, but no significant interaction (group X
measure) effect, F(2,122) = 0.65, p = .526, partial eta squared
= .010. For Performance IQ, there was a significant difference
from pre-intervention to post-intervention, F(1,122) = 22.94, p
< .001, partial eta squared = .158, but no significant interaction
(group X measure) effect, F(2,122) = 0.44, p = .644, partial eta
squared = .007. For Full Scale IQ, there was a significant dif-
ference from pre-intervention to post-intervention, F(1,122) =
32.07, p < .001, partial eta squared = .208, but no significant
interaction (group X measure) effect, F(2,122) = 0.38, p = .684,
partial eta squared = .006. For PPVT, there was no significant
difference from pre-intervention to post-intervention, F(1,128)
= 0.13, p = .717, partial eta squared = .001, and the interaction
effect was not significant, F(2,128) = 1.19, p = .307, partial eta
squared = .018. The details are in Table 3.
Intention-to-Treat An alysis
In this section, the analysis was based on intention-to-treat.
For participants with missing post-intervention data, their
pre-intervention data was used as substitute. This approach is
commonly used in studies on the evaluation of parent training
programs (e.g. Hutchings et al. 2007; Sanders, Prior & Ralph,
2009).
Parent Outcome Measures. There was a significant differ-
ence for pre-intervention and post-intervention measures,
F(1,133) = 14.85, p < .001, partial eta squared = .100, and a
significant interaction effect (type of organization X measure)
for ECBI-intensity, F(2,133) = 4.12, p = .018, partial eta
squared = .058. For ECBI-problem, there was a significant
difference for pre-intervention and post-intervention measures,
F(1,133) = 34.19, p < .001, partial eta squared = .205, but the
interaction effect (type of organization X measure) was not
significant, F(2,133) = 2.01, p = .138, partial eta squared = .029.
For social support, there was a significant difference for
pre-intervention and post-intervention measures, F(1,130) =
9.64, p = .002, partial eta squared = .069, and the interaction
effect (type of organization X measure) was also significant,
F(2,130) = 5.98, p = .003, partial eta squared = .084. There was
a significant difference for pre-intervention and post-interven-
tion PSI measures, F(1,130) = 24.26, p < .001, partial eta
squared = .157, and the interaction effect (type of organization
X measure) for PSI was also significant, F(2,130) = 4.42, p
= .014, partial eta squared = .064. For self-efficacy, there was a
significant difference for pre-intervention and post-intervention
measures, F(1,133) = 4.03, p = .047, partial eta squared = .029,
but the interaction effect (type of organization X measure) was
not significant, F(2,133) = 0.43, p = .654, partial eta squared
= .006.
Child Outcome Measures. For Verbal IQ, there was a sig-
nificant difference from preintervention to post-intervention,
F(1,135) = 16.98, p < .001, partial eta squared = .112, but there
was no significant interaction (group X measure) effect, F
(2,135) = 0.26, p = .775, partial eta squared = .004. For Per-
formance IQ, there was a significant difference from pre-in-
tervention to post-intervention, F(1,135) = 22.42, p < .001,
partial eta squared = .142, but there was no interaction (group X
measure) effect, F(2,135) = 0.31, p = .734, partial eta squared
= .005. For Full Scale IQ, there was a significant difference
from pre-intervention to post-intervention, F(1,135) = 30.76, p
< .001, partial eta squared = .186, but there was no significant
interaction (group X measure) effect, F(2,135) =0.03, p = .968,
partial eta squared = .000. For PPVT, there was no significant
ifference from pre-intervention to post-intervention, F(1,136) d

C. LEUNG ET AL.
Table 3.
Pre, and post-intervention scores with 95% confidence interval and reliability estimates (α) (where appropriate) for pair wise comparison.
IP (n = 66) IS (n = 21) C (n = 54) Total
Mean (95% CI) α Mean (95% CI) α Mean (95% CI) α Sig
Pre ECBI-Intensity 119.62 [113.22, 122.03]
(n = 66) .93 111.80 [100.07, 123.53] (n = 20) .91117.60 [110.99, 124.21] (n = 50) .92 F(2,133) = 0.76, p = .471
Post ECBI-Intensity 109.45 [104.55, 114.35]
(n = 60) .92 95.94 [84.58, 107.29] (n = 16) .92118.21 [111.17, 125.26] (n = 42) .93 F(2,115) = 6.93, p = .001
Pre ECBI-
Problem
10.95 [8.91, 13.00]
(n = 66) .92 9.45 [5.63, 13.27] (n = 20) .9311.56 [9.25, 13.87] (n = 50) .91 F(2,133) = 0.47, p = .626
Post ECBI-
Problem
5.30 [3.34, 7.26]
(n = 60) .95 3.38 [1.24, 5.51) (n = 16) .848.83 [6.56, 11.10] (n = 42) .91 F(2,115) = 4.61, p = .012
Pre PSI 99.55 [95.49, 103.60]
(n = 64) .90 96.20 [89.26, 103.14] (n = 20) .8797.41 [92.57, 102.24] (n = 49) .91 F(2,130) = 0.43, p = .653
Post PSI 87.63 [84.19, 91.08]
(n = 60) .89 91.63 [84.74, 98.51] (n = 16) .8191.69 [87.08, 96.30] (n = 42) .89 F(2,115) = 1.26, p = .288
Pre Social Support 25.84 [24.30, 27.39]
(n = 64) .82 24.25 [20.56, 27.94] (n = 20) .8425.71 [23.86, 27.57] (n = 49) .85 F(2,130) 0.47, p = .624
Post Social support 30.13 [28.69, 31.58]
(n = 60) .90 25.94 [21.58, 30.29] (n = 16) .8827.33 [25.50, 29.16] (n = 42) .79 F(2,115) =4.34, p = .015
Pre Self-efficacy 24.47 [ 23.35, 25.59]
(n = 66) .83 22.45 [19.71, 25.19] (n = 20) .8524.60 [22.90, 26.30] (n = 50) .90 F(2,133) = 1.31, p = .273
Post Self-efficacy 25.28 [23.90, 26.67]
(n = 60) .87 23.31 [20.14, 26.48] (n = 16) .8723.93 [22.09, 25.77] (n = 42) .90 F(2,115) = 1.15, p = .321
Pre Verbal IQ 100.38 [96.99, 103.78]
(n = 65) NA 101.86 [97.19, 106.53] (n = 21) NA96.40 [93.40, 99.41] (n = 52) NA F(2,133) =2.17, p = .119
Post Verbal IQ 104.03 [100.92, 107.15]
(n = 62) NA 109.13 [102.48, 115.79] (n = 15) NA101.68 [98.98, 104.37] (n = 50) NA F(2,124) = 2.60, p = .078
Pre Performance IQ 101.92 [98.18, 105.67]
(n = 66) NA 106.00 [100.44, 111.56] (n = 21) NA105.00 [100.68, 109.32] (n = 52) NA F(2,136) =0.91, p = .404
Post Performance IQ 108.32 [104.372, 112.28]
(n = 62) NA 114.27 [107.05, 121.48] (n = 15) NA110.64 [106.877, 114.41] (n = 50) NA F(2,124) =1.12, p = .328
Pre Full Scale IQ 100.74 [97.22, 104.25]
(n = 65) NA 104.29 [99.06, 109.51] (n = 21) NA100.37 [96.80, 103.93] (n = 52) NA F(2,135) = 0.71, p = .496
Post Full Scale IQ 106.81 [103.47, 110.14]
(n = 62) NA 113.07 [106.22, 119.91] (n = 15) NA106.78 [103.77, 109.79] (n = 50) NA F(2,124)= 1.78, p = .173
Pre PPVT 111.05 [106.99, 115.10]
(n = 66) NA 109.38 [103.54, 115.22] (n = 21) NA108.81 [106.12, 111.50] (n = 53) NA F(2,137)= 0.41, p = .665
Post PPVT 107.40 [104.24, 110.56]
(n = 63) NA 111.26 [105.59, 116.94] (n = 19) NA108.82 [104.77, 112.87] (n = 50) NA F(2,129)= 0.66, p = .519
192

C. LEUNG ET AL.
= 0.17, p = .685, partial eta squared = .001, and the interaction
effect was not significant, F(2,136) = 1.23, p = .296, partial eta
squared = .018.
Qualitative Information
As the main difference between the preschool group and the
social services group was the context or setting where the pro-
gram was conducted, rather than the program content or activi-
ties, the focus of the discussion in this section was on the con-
textual factors influencing the program. The information was
mainly derived from the interviews with the preschool princi-
pals and social services centre supervisors. They were the key
people who “created” the context for the delivery and imple-
mentation of the program.
When the preschool principals and the social services centre
supervisors were asked about their perceived objectives of the
program, there were subtle differences. Though both stated that
the program was to equip new immigrant parents with parent-
ing skills, the preschool principals (educators) stated explicitly
that the program could help the children and their learning
whereas the centre supervisors (social workers) emphasized
that the program could help parents learn how to manage their
children. One might argue that the centre supervisors focused
more on the parents whereas the preschool principals focused
more on children.
In terms of their own roles, both centre supervisors and pre-
school principals claimed that they played a coordinating role.
The centre supervisors further maintained that they were inter-
ested in wider issues such as the effectiveness of the program
and community liaison. The preschool principals focused on
their roles in the day-to-day running of the program.
Both centre supervisors and preschool principals reported
positive changes in child learning, behavior, parenting and par-
ent-child relationship. Being more child-centred in their service
and set up, the preschool principals reported their direct first-
hand observation of changes in children, such as their learning,
or behavior. With a focus on both youth and parents, the centre
supervisors gathered such information from the report of the
parents.
One of the purposes of the group sessions was to provide a
platform to facilitate new immigrant parents to build up their
social network. Both preschool principals and social services
centre supervisors reported their observations of increased par-
ent social interaction and support.
With respect to the benefits of the program to the preschools
and social services centres, both parties could list benefits.
However, the focus was quite different. The centre supervisors
were more adult-focused and elaborated on the participants’
relationship with the centre and emphasized that the social ser-
vices centre was a resource to support parents. The preschool
principals were more child-focused and discussed the benefits
in terms of benefit for the children, as well as changes in par-
ent-school relationship.
Finally, both parties were invited to comment on the delivery
of the program within their setting. Both could identify some
specific benefits, though one of the centre supervisors did iden-
tify some difficulties in relation to recruitment, which, in a way,
could be made easier in the preschool setting.
It is understandable that there might be a problem with
stigma for using social services centres. For many parents, there
is no perceived requirement for service use, or regular/intensive
attendance. Social services centres are likely to assess success
by the clients’ help-seeking willingness, and connection with
centre is an important indicator. For preschools, education is
perceived by parents as essential and so the motivation is dif-
ferent. Parents probably accept regular and intensive attendance
to school as essential and normal.
Discussion
The quantitative results indicated that there were significant
differences in post-intervention social support, favoring the
preschools relative to social services centres. These outcomes
were parent outcomes. Both preschools and social services
centres were effective in producing decrease in child behavior
problems (ECBI-intensity). There was a marginal difference in
drop-out rate with a higher percentage of drop-out cases in
social services centres (IS group).
There was a difference between the preschools and social
service centres in terms of perceived target clients for the pro-
gram. For the preschools, the target clients were the school
children. It was obvious that preschools joined the program
because they considered that the program could benefit the
children as an early intervention program, through empowering
and equipping the parents, and they could observe changes in
the children directly. In the end, they thought the program could
help the school because it helped the children. For the social
services centres, the focus shifted to adults and they hoped to
provide support to the parents and to build up their connections
with the centre. The supervisors thought that the program could
help the parents, and this could also help to improve the rela-
tionship between the parents and the centre. This is consistent
with Gross and Grady (2006) who claimed that it was important
for the organization to perceive the goal of the parenting pro-
gram as consistent with the goals of the organization.
One possible advantage of the preschool is that it is a famil-
iar setting for the new immigrant parents. This is a facilitating
factor. Furthermore, the preschools are more likely to be in a
location convenient to the parents and this is another incentive.
It is also possible that being invited by the preschool principal
to attend a school program is less stigmatizing than attending a
parenting program in a social services centre, which might still
be seen as a place for people with problems. This is, to some
extent, substantiated by the quantitative findings where the
drop-out rate was lower among preschool participants. On the
other hand, there could be creative collaboration between social
services centres and preschools. Social workers could deliver
the parenting program in preschools and this would provide
additional resources for preschools to realize their goals of
promoting child development. This can be regarded as a crea-
tive solution to the resource problems in Hong Kong preschools
(Rao & Li, 2009). Through the program, social workers can
also introduce the parents to the services of their social services
centres and to encourage the parents to make use of the centre
resources, thus building up the connection between the parents
and the centres. Knowledge/awareness of available services and
perceived accessibility of service are important considerations
(Leong & Lau, 2001) for help-seeking behaviour.
According to Gross and Grady (2006), the support of the
administration is important to maintain participation and moti-
vation. The preschools could see that the program could en-
hance parent-school relationship, and is in line with Epstein’s
model of home-school collaboration (Epstein, 2001). Both the

C. LEUNG ET AL.
teachers and the program consistently reinforced the parenting
skills and this also led to better home-school co-operation and
communication. Furthermore, the program and the teachers
could complement and reinforce each other in equipping and
supporting the parents to promote the development of the chil-
dren. The improved relationship with the preschool, the support
and encouragement of preschool principals and teachers might
be another incentive for attending the program and a possible
reason for decrease in parenting stress. On the other hand, so-
cial services centres also see the program as an important
means to engage parents and to build up a relationship between
the parents and the centre. A social services centre is also
equipped with an array of professional resources which can
support parents with various personal and family needs. There
might be parents with personal or family problems or financial
problems, and social services centres are in a much better posi-
tion to support these parents. They have trained social workers
with expertise and knowledge in these areas. Shriver and Allen
(2006) have pointed out that intensive individual treatment
protocols might not be viable in preschools.
The quantitative results indicated a significant difference in
post-intervention social support between the two groups. In
preschools, the program provided a platform for parents to fur-
ther develop their friendship as they might have known each
other before the program. For the social services centre, the
parents might be strangers to each other before the program and
more time might be needed to build up a supportive and trust-
ing relationship. On the other hand, social services centres with
flexible opening hours can provide a venue for parents to gather
together, both formally and informally, whereas preschools
might be more limited by space or opening hours.
Limitations
First, this study may somehow be regarded as a post hoc
study as we did not set out to investigate the issue of contextual
influence on program effectiveness. However, the results do
provide useful insight for practice, and useful research ques-
tions for future studies. Second, complete randomization was
not used in group allocation in the sense that all social services
centres were offered the HOPE program, and there might be
subtle differences in the participants which could be potential
confounders. However, there was no significant difference
between the three groups (IP and C preschools and social ser-
vices centres) in most demographic characteristics or pre-in-
tervention scores. Third, the child measures were tests stan-
dardized with Chinese children in Taiwan, rather than Hong
Kong. The researchers were fully aware of the limitations of
these tests but at the time of the study, there was no cognitive
test for preschool children normed for Hong Kong Chinese
children. Fourth, some parents dropped out from the study due
to various reasons, including perceived inappropriateness of the
program, child care and employment issues. There were more
working mothers among the drop-out cases and their pre-in-
tervention self-efficacy scores were lower. There was a mar-
ginally statistically significant difference in drop-out among the
three groups, with more drop-out cases in the IS group, though
the drop-out in the IP group was the lowest among the three
groups. These might have implications for the external validity
of the program, as we could not generalize the results to the
drop-out participants. For internal validity, we have conducted
intention-to-treat to include the data of the drop-out cases in the
analysis, to deal with differential loss to follow-up. Finally,
there was no independent validation of treatment fidelity, al-
though a detailed manual was available and facilitators were
instructed to adhere closely to the manual.
Implications for Services
While preschools and social services centres are possible set-
tings where early intervention programs such as parent training
can be offered, they have different strengths which should be
fully utilized by policy makers and service planners. In the
Hong Kong situation, preschools may be limited by funding
resources, and social services centres might have service quota
to meet. This creates a unique opportunity for the two to col-
laborate to reach the target parents for early intervention pro-
grams. However, it is also important to understand the unique
community profile, location and accessibility of the facilities,
and use different promotion strategies to attract parents. The
different funding and services arrangements of preschools and
social services centres and their constraints must also be taken
into consideration. Preschools and social services centres may
need to allow for additional input such as adding social func-
tions to enhance social networking; or casework support to
parents with psychosocial difficulties.
For tertiary institutions collaborating with preschools or so-
cial services centres in implementing or evaluating early inter-
vention programs such as parent training programs, briefing to
the principals and centre supervisors should also be tailor-made
to ensure they fully understand the potential contributions of
the program. Engagement of the staff is also important so they
do not perceive the program as an additional burden or a means
to fulfill the quota set by the government or sponsor. The re-
search/program mindset of the personnel is also important as
this will affect their devotion to the program.
Acknowledgements
This study is supported by a Public Policy Research Fund,
Research Grants Council, Hong Kong. The authors gratefully
acknowledge the participation of the parents and their permis-
sion for us to report the results of the program in this article.
REFERENCES
Barlow, J., & Parsons, J. (2005). Group-based parent-training pro-
grammes for improving emotional and behavioural adjustment in 0-3
year old children. Campbell Systematic Reviews, 3.
Broadhead, W. E., Gehlbach, S. H., De Gruy, F. V., & Kaplan, B. H.
(1988). The Duke-UNC functional social support questionnaire:
Measurement of social support in family medicine patients. Medical
Care, 26, 709-723. doi:10.1097/00005650-198807000-00006
Census and Statistics Department (2007a). 2006 Population by-census
thematic report: Persons from the mainland having resided in Hong
Kong for less than 7 years. Hong Kong: Hong Kong SAR Govern-
ment Census and Statistics Department.
Census and Statistics Department (2007b). 2006 Population by-census
thematic report: Household income distribution in Hong Kong. Hong
Kong: Hong Kong SAR Government Census and Statistics Depart-
ment.
Cunningham, C. E., Bremner, R. B., & Boyle, M. (1995). Large group
community-based parenting programs for families of preschoolers at
risk for disruptive behavior disorders: Utilization, cost effectiveness,
and outcome. Journal of Child Psychology and Psychiatry, 36, 1141-
1159. doi:10.1111/j.1469-7610.1995.tb01362.x
194

C. LEUNG ET AL.
Dunn, L. M., & Dunn, L. M. (1994). The Peabody Picture Vocabulary
Test Revised (Form L) (PPVT-R; Taiwanese Version). Taipei: The
Psychological Publishing Co. Ltd.
Epstein, J. L. (2001). School, family and community partnerships:
Preparing educators and improving schools. Oxford: Westview
Press.
Eyberg, S. M., & Ross, A. W. (1978). Assessment of child behaviour
problems: The validation of a new inventory. Journal of Clinical
Psychology, 16, 113-116.
Gross, D., & Grady, J. (2002). Group-based parent training for pre-
venting mental health disorders in children. Issues in Mental Health
Nursing, 23, 367-384. doi:10.1080/01612840290052578
Hutchings, J., Bywater, T., Daley, D., Gardner, F., Whitaker, C., Jones,
K., Eames, C., & Edwards, R. T. (2007). Parenting intervention in
Sure Start services for children at risk of developing conduct disorder:
Pragmatic randomized controlled trial. BMJ, 334, 678.
doi:10.1136/bmj.39126.620799.55
Kohl, P. L., Schurer, J., & Bellamy, J. L. (2009). The state of parent
training: Program offerings and empirical support. Families in Soci-
ety, 90, 248-254.
Lam, D. (1999). Parenting stress and anger: The Hong Kong experience.
Child and Family Social Work, 4, 337-346.
doi:10.1046/j.1365-2206.1999.00133.x
Leong, F. T. L., & Lau, A. S. L. (2001). Barriers to providing effective
mental health services to Asian Americans. Mental Health Services
Research, 3, 201-214. doi:10.1023/A:1013177014788
Leung, C. M., Chan, S. C. M., Pang, R. C. Y., & Cheng, W. K. C.
(2003). Validation of the Chinese version of the eyberg child behav-
iour inventory for use in Hong Kong. Wanchai, Hong Kong: Educa-
tion and Manpower Bureau.
Leung, C., Ip, F., Tso, K., & Leung, S. (2003). Parenting programme in
the Family Health Service. Public Health & Epidemiology Bulletin,
12, 49-53.
Leung, C., Leung, S. S. L., & Chan, R. (2007). The adaptation of
mainland Chinese immigrant parents of preschool children in Hong
Kong. E-Journal of Applied Psychology, 3, 43-57.
Leung, C., Tsang, S., & Dean, S. (2010). Evaluation of a program to
educate disadvantaged parents to enhance child learning. Research
on Social Work Practice, 20, 591-599.
doi:10.1177/1049731510362224
Leung, C., Tsang, S., & Dean, S. (2011). Outcome evaluation of the
Hands-On Parent Empowerment (HOPE) Program. Research on So-
cial Work Practice.
Leung, C., Tsang, S., Dean, S., & Chow, P. (2009). Development and
pilot evaluation of the “Hands on Parent Empowerment” (HOPE)
project—A parent education programme to establish socially disad-
vantaged parents as facilitators of preschool children’s learning.
Journal of Children’s Services, 4, 21-32.
Lo, K. T., Wan, A., & Chung, L. (1999). A survey study on the psycho-
logical adaptation of newly arrived students from mainland China.
Hong Kong: Aberdeen Kai-Fong Welfare Association Social Service
Centre.
Rao, N., & Li, H. (2009). Quality matters: Early childhood education
policy in Hong Kong. Early Child Development and Care, 179, 233-
245. doi:10.1080/03004430601078644
Reyno, S. M., & McGrath, P. J. (2006). Predictors of parent training
efficacy for child externalizing behavior problem—A meta-analytic
review. Journal of Child Psychology and Psychi a tr y , 47, 99-111.
doi:10.1111/j.1469-7610.2005.01544.x
Sanders, M. R., Prior, J., & Ralph, A. (2009). An evaluation of a brief
universal seminar series on positive parenting: A feasibility study.
Journal of Children’s Services, 4, 4-20.
Schwarzer, R. (1993). Measurement of perceived self-efficacy: Psy-
chometric scales for cross-cultural research. Berlin: Zentrale Univer-
sitats Druckerei der FU Berlin.