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Home-based parenting programs designed to prevent child abuse and neglect have become wide-spread with efforts to reach families of young children at risk. Rural and urban communities likely differ in strategies to access and recruit families. This study examined rural and urban community differences from a sample of over 1,300 parents referred for home-based parenting services designed to prevent child abuse and neglect. Rural families were much more likely to be self-referred (35%), compared to urban families (7.5%). Urban families were more likely to be referred by health/medical agencies (35.4%) and basic needs support programs (26.1%), than rural families (16.7% and 5.2%), respectively. After controlling for demographic factors, referral sources of self and child welfare did not predict enrollment or completion. However, both rural and urban families were almost 21 times more likely to complete the child abuse prevention program if they were provided referrals to outside goods and services while participating in the child abuse prevention program (odds ratio = 20.85; 95% confidence interval [12.98, 35.01]; p < .001). Implications for recruitment and engagement of families in home-based child abuse prevention programs are discussed.