Development of a Fidelity Instrument for Delivering the Alert Program ® for Self-Regulation
Abstract
Rationale/Background: The Alert Program® (AP) is widely used to support children with self-regulation challenges, yet inconsistent implementation may affect outcomes. A standardized fidelity measure is needed to ensure consistent delivery across research and practice settings. Objectives: To develop and validate a fidelity measure for assessing AP implementation for children with self-regulation needs. Methodology: Using an implementation framework, we conducted a narrative literature review following SANRA guidelines to identify structural, process, and content elements essential to AP delivery. A preliminary fidelity measure underwent expert review, revision, and inter-rater reliability assessment. Results: The literature review identified 14 studies with varying coverage of fidelity elements. Expert review ( n = 4) demonstrated 93.4% agreement on core elements. Inter-rater reliability assessment showed 91% agreement between independent raters. Conclusion : The developed fidelity measure provides a foundation for research using the AP and offers practitioners a method to ensure implementation consistency in supporting children with self-regulation challenges.
Fields of Study & Subjects
Behavioral and Psychological Studies
Early Childhood Education and Development
Health Policy Implementation Science
Publication details
- Journal / source
- OTJR Occupational Therapy Journal of Research
- Pages
- 15394492261422638–15394492261422638
- Publication date
- 3 March 2026
- Language
- EN