title: The development of a culturally appropriate school based intervention for Australian Aboriginal children living in remote communities: A formative evaluation of the Alert Program®intervention.
abstract: OBJECTIVE
  Although previous research has demonstrated the benefits of targeting self-regulation in non-Aboriginal children, it is unclear whether such programs would be effective for Aboriginal children attending school in remote communities. Some of these children have been diagnosed with a fetal alcohol spectrum disorder (FASD) impairing their ability to self-regulate. The aim of this article is to describe a three phase formative process to develop and pilot a curriculum version of the Alert Program®, a promising intervention for improving self-regulation that could be used in remote community schools. This modified version of the program will be subsequently tested in a cluster randomised controlled trial.
  
  
  METHODS
  A mixed methods approach was used.
  
  
  RESULTS
  Modifications to the Alert Program®, its delivery and evaluation were made after community and stakeholder consultation facilitated by a senior Aboriginal community researcher. Changes to lesson plans and program resources were made to reflect the remote community context, classroom environment and the challenging behaviours of children. Standardised study outcome measures were modified by removing several questions that had little relevance to the lives of children in remote communities. Program training for school staff was reduced in length to reduce staff burden.
  
  
  CONCLUSIONS
  This study identified aspects of the Alert Program®training, delivery and measures for evaluation that need modification before their use in assessing the efficacy of the Alert Program®in remote Aboriginal community primary schools.
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Australia.
authors.forename: Bree
authors.initials: B
authors.lastname: Wagner
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Fitzpatrick
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Australia.
authors.forename: Martyn
authors.initials: M
authors.lastname: Symons
authors.affiliation: Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Jirikowic
authors.affiliation: Faculty of Medicine, Dentistry and Health Science, Telethon Kids Institute, The University of Western Australia, Australia.|Edith Cowan University, Perth, Western Australia, Australia.
authors.forename: Donna
authors.initials: D
authors.lastname: Cross
authors.affiliation: The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Latimer
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003256:Community Participation / Q000379:methods; D055812:Community-Based Participatory Research / Q000458:organization & administration; D054521:Cultural Competency; D003479:Curriculum; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000208:ethnology / Q000534:rehabilitation*; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D008297:Male; D009788:Occupational Therapy / Q000458:organization & administration*; D010865:Pilot Projects; D016730:Program Development; D012424:Rural Population; D012572:School Health Services / Q000458:organization & administration*
keywords: Indigenous; executive function; fetal alcohol spectrum disorders; paediatric; rural and remote health