Attachment and Biobehavioral Catch-up (ABC) demonstrates efficacy in improving parent and child outcomes, with preliminary evidence for effectiveness in community settings. The objective of this study was to assess the effectiveness of a community-based ABC implementation in improving parent outcomes as well as to examine potential mediators and moderators of intervention effectiveness. Two hundred parents and their 5- to 21-month-old infants recruited from an urban community were randomly assigned to receive ABC or be placed on a waitlist. The majority of participants had a minority racial or ethnic background. Before intervention, parents completed questionnaires about sociodemographic risk and adverse childhood experiences. At both baseline and follow-up, parents reported depression symptoms and were video-recorded interacting with their infant, which was coded for sensitivity. The ABC intervention predicted significant increases in parental sensitivity and, among parents who completed the intervention, significant decreases in depression symptoms. Changes in parental depression symptoms did not significantly mediate the intervention effects on sensitivity. Risk variables did not moderate the intervention effects. The results indicate that ABC shows promise for improving parent outcomes in community settings, supporting dissemination.

Toddlers in foster care have typically experienced histories of maltreatment and disruptions in relationships with primary caregivers. As a result, they are at increased risk for developing disorganized attachment and showing emotional, behavioral, and physiological dysregulation. Attachment and Biobehavioral Catch-up for Toddlers in Foster Care (ABC-T) was developed to address the needs of these vulnerable children by supporting foster parents in responding with nurturance to children's distress, following children's lead, and helping children calm when they are becoming overwhelmed or dysregulated. We describe the theoretical underpinnings, evidence base, and clinical approach of ABC-T. Using a case example of Luna and her foster mother Ms. Rosio, we present the typical course of ABC-T, demonstrating core aspects of the model including ongoing observation of parent-child interactions and "in the moment" commenting. Additionally, we consider several challenges to delivering attachment-based interventions in the context of foster care.

Background Personalized feedback is an effective behavior change technique frequently incorporated into mobile health (mHealth) apps. Innovations in data science create opportunities for leveraging the wealth of user data accumulated by mHealth apps to generate personalized health forecasts. One Drop’s digital program is one of the first to implement blood glucose forecasts for people with type 2 diabetes. The impact of these forecasts on behavior and glycemic management has not been evaluated to date. Objective This study sought to evaluate the impact of exposure to blood glucose forecasts on blood glucose logging behavior, average blood glucose, and percentage of glucose points in range. Methods This retrospective cohort study examined people with type 2 diabetes who first began using One Drop to record their blood glucose between 2019 and 2021. Cohorts included those who received blood glucose forecasts and those who did not receive forecasts. The cohorts were compared to evaluate the effect of exposure to blood glucose forecasts on logging activity, average glucose, and percentage of glucose readings in range, after controlling for potential confounding factors. Data were analyzed using analysis of covariance (ANCOVA) and regression analyses. Results Data from a total of 1411 One Drop users with type 2 diabetes and elevated baseline glucose were analyzed. Participants (60.6% male, 795/1311; mean age 50.2 years, SD 11.8) had diabetes for 7.1 years on average (SD 7.9). After controlling for potential confounding factors, blood glucose forecasts were associated with more frequent blood glucose logging (P=.004), lower average blood glucose (P<.001), and a higher percentage of readings in range (P=.03) after 12 weeks. Blood glucose logging partially mediated the relationship between exposure to forecasts and average glucose. Conclusions Individuals who received blood glucose forecasts had significantly lower average glucose, with a greater amount of glucose measurements in a healthy range after 12 weeks compared to those who did not receive forecasts. Glucose logging was identified as a partial mediator of the relationship between forecast exposure and week-12 average glucose, highlighting a potential mechanism through which glucose forecasts exert their effect. When administered as a part of a comprehensive mHealth program, blood glucose forecasts may significantly improve glycemic management among people living with type 2 diabetes.

Improving diabetes management skills and reducing diabetes-related distress in working adults with type 2 diabetes has implications for work-related outcomes including work productivity. Digital health programs have the potential to positively impact diabetes management and, in turn, improve the productivity of working-age adults.

Children who experience early adversity often show alterations across multiple stress response systems, including the hypothalamic–pituitary–adrenal (HPA) axis and autonomic nervous system (ANS). Changes in the diurnal rhythm of salivary cortisol (a marker of HPA axis functioning) and alpha‐amylase (a marker of ANS functioning) may increase their probability of developing behavior problems. The goal of this study is to examine how these analytes may interact to predict externalizing behavior in infants exposed to early stress. Participants included 179 parents and their 6‐ to 20‐month old infants recruited from a low‐income neighborhood. Parents reported on their infants’ externalizing behaviors and collected saliva samples from their children at wake‐up and bedtime over three days. Diurnal cortisol and alpha‐amylase were modeled using latent difference scores. Four models were tested examining the effects of cortisol and alpha‐amylase morning values and slopes, as well as their interactions, on externalizing behavior. Results showed a significant interaction effect of cortisol and alpha‐amylase morning values, such that low morning cortisol was associated with decreased externalizing behavior when morning alpha‐amylase was high but not low. These findings highlight the importance of examining multiple systems when characterizing the physiological correlates of externalizing behavior among infants experiencing adversity.