Changing parental depression and sensitivity: Randomized clinical trial of ABC's effectiveness in the community.

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.

Developing self-regulation in a dysregulating world: Attachment and Biobehavioral Catch-up for a toddler in foster care.

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.

Effects of a Novel Blood Glucose Forecasting Feature on Glycemic Management and Logging in Adults With Type 2 Diabetes Using One Drop: Retrospective Cohort Study.

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.

One Drop Improves Productivity for Workers With Type 2 Diabetes: One Drop for Workers With Type 2 Diabetes.

OBJECTIVE: Diabetes research on work productivity has been largely cross-sectional and retrospective, with only one known randomized controlled trial (RCT) published, to our knowledge. Secondary analysis of the Fit-One RCT tested the effect of One Drop's digital health program on workplace productivity outcomes, absenteeism, and presenteeism, for employees and specifically for older workers with type 2 diabetes. METHODS: Analysis of the 3-month Fit-One trial data from employees who have type 2 diabetes explored productivity using logistic analyses and generalized estimating equations. RESULTS: Treatment and control group comparisons showed that workers ( N = 125) using One Drop see direct benefits to workplace productivity, which leads to productivity savings for employers. CONCLUSION: This was the first RCT to demonstrate that a mobile health application for managing type 2 diabetes can positively affect productivity at work.