Development of a Fidelity Instrument for Delivering the Alert Program <sup>®</sup> for Self-Regulation

<b>Rationale/Background:</b> 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. <b>Objectives:</b> To develop and validate a fidelity measure for assessing AP implementation for children with self-regulation needs. <b>Methodology:</b> 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. <b>Results:</b> The literature review identified 14 studies with varying coverage of fidelity elements. Expert review (<i>n</i> = 4) demonstrated 93.4% agreement on core elements. Inter-rater reliability assessment showed 91% agreement between independent raters. <b>Conclusion</b>: 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.

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Publication Details

Journal
OTJR Occupational Therapy Journal of Research
Published
2026-03-03
DOI
https://doi.org/10.1177/15394492261422638
Primary Topic
Behavioral and Psychological Studies
Type
article
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article

Development of a Fidelity Instrument for Delivering the Alert Program ® for Self-Regulation

Shelly J. Lane, Dianne Blackwell, Alison E. Lane, Kelsey Philpott-Robinson
OTJR Occupational Therapy Journal of Research
Behavioral and Psychological Studies
article

Development of a Fidelity Instrument for Delivering the Alert Program ® for Self-Regulation

Shelly J. Lane, Dianne Blackwell, Alison E. Lane, Kelsey Philpott-Robinson
article en

Abstract

<b>Rationale/Background:</b> 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. <b>Objectives:</b> To develop and validate a fidelity measure for assessing AP implementation for children with self-regulation needs. <b>Methodology:</b> 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. <b>Results:</b> The literature review identified 14 studies with varying coverage of fidelity elements. Expert review (<i>n</i> = 4) demonstrated 93.4% agreement on core elements. Inter-rater reliability assessment showed 91% agreement between independent raters. <b>Conclusion</b>: 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.

OTJR Occupational Therapy Journal of Research
La Trobe University (AU), University of Newcastle Australia (AU), Colorado State University (US)
Openalex Percentile: Top 38%
Behavioral and Psychological Studies
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Development of a Fidelity Instrument for Delivering the Alert Program <sup>®</sup> for Self-Regulation — Shelly J. Lane, Dianne Blackwell, et al. · OTJR Occupational Therapy Journal of Research (2026) | TGRS Research Map | TGRS