Differential Effects of In-person and Telehealth Implementation of Attachment and Biobehavioral Catch-up on Parental Sensitivity and Intrusiveness

BACKGROUND: Attachment and Biobehavioral Catch-up (ABC) is a home visiting program designed for parents of children between birth and 48 months of age who have experienced early adversity. Previous research demonstrated that ABC enhances parental sensitivity and reduces parental intrusiveness through both in-person and hybrid delivery methods (Roben et al.in Child Development 88(5):1447–1452, 2017, https://doi.org/10.1111/cdev.12898 ; Schein et al. in Child Maltreatment28(1):24–33, 2023, https://doi.org/10.1177/10775595211072516 ). However, the relative effectiveness of in-person versus exclusive telehealth implementation had yet to be explored. METHODS: The current study examined changes in parental sensitivity and intrusiveness from pre- to post-intervention in community implementation settings among 201 families receiving ABC either in-person or via telehealth. Parenting behaviors were analyzed through coded video recordings of parent-child free play interactions, collected before and after the intervention. RESULTS: Parental sensitivity increased for both implementation methods, with in-person delivery showing significantly greater improvement than telehealth. Parental intrusiveness also decreased for both groups, with no significant difference between the two implementation methods. CONCLUSIONS: ABC was effective in improving parenting behaviors when delivered both in person and via telehealth in real-world community settings. Findings suggest that while telehealth delivery is a viable implementation option, in-person services may offer additional benefits for enhancing parental sensitivity, with implications for service delivery decisions in home visiting programs.