Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that presents many challenges for parents and service providers. Unfortunately, there are limited examples of parent-mediated interventions for parents of children with ASD that can help manage behavioral problems, especially those that can be implemented in both urban and rural communities. COMPASS for Hope (C-HOPE) is an 8-week parent-mediated intervention that enhances parent knowledge, behavior management skills, and supportive strategies. Telehealth-based interventions can be especially effective for rural communities due to its ability to address common barriers of geographic location and lack of resources. When implementing this intervention, the ability to decrease child problem behaviors as well as increase parental activation, self-management, perceived competence, and knowledge are essential to determine the efficacy of this treatment. The purpose of the current study is to evaluate these outcomes in the implementation of C-HOPE via telehealth in rural versus urban communities. 20 parents with children from 3-12 years of age with a diagnosis of ASD were sampled from two rural sites and two urban sites in Kentucky. Few differences were noted between the participants in the rural versus urban group at pre-treatment. Following C-HOPE, in the urban area, there were significant treatment effects in parent knowledge outcomes. In the rural areas, a significant effect was found in change of parent self-management skills of toileting issues. Future directions for telehealth treatments for this population are discussed.