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.