The development of a culturally appropriate school based intervention for Australian Aboriginal children living in remote communities: A formative evaluation of the Alert Program<sup>®</sup>intervention

Wagner, Bree; Fitzpatrick, James; Symons, Martyn; Jirikowic, Tracy; Cross, Donna; Latimer, Jane

doi:10.1111/1440-1630.12352

Cited by 18 publications

(34 citation statements)

References 24 publications

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“…In Italy, the prevalence of FASD was reported to be 23 to 47 per 1000 in first-grade pupils [ 7 ], while in Croatia, it was estimated to be 40 per 1000 in elementary school children [ 8 ]. In four communities of USA, the prevalence was estimated to be 11 to 50 per 1000 children [ 9 ], and in a secluded Indigenous population in Australia the reported prevalence was 194.4 per 1000 children [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring service providers’ perspectives on the prevention and management of fetal alcohol spectrum disorders in South Africa: a qualitative study

et al. 2018

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BackgroundFetal alcohol spectrum disorder (FASD) is among the leading causes of developmental and intellectual disabilities in individuals. Although efforts are being made toward the prevention and management of FASD in South Africa, the prevalence remains high. The sustained high prevalence could be attributed to several factors, including the lack of policy for a coordinated effort to prevent, diagnose and manage FASD nationally. In this study, our aim was to explore the perspectives of service providers (health and allied professionals, teachers, social workers) on the prevention and management of FASD towards developing a guideline to inform policy.MethodGuided by the exploratory qualitative research design, we purposively sampled relevant service providers in the field of FASD prevention and management for focus group discussions. Nine of these discussions were conducted with to eight participants per discussion session. The discussants were asked various questions on the current and required interventions and practices for the prevention and management of FASD. Following the Framework Method, data were transcribed verbatim and analysed using the thematic content analysis approach.ResultsOur findings show that aspects of the prevention and management of alcohol-related conditions are present in various policies. However, there is no clear focus on coordinated, multi-sectoral efforts for a more comprehensive approach to the prevention and management of FASD. The participants recognized the need for specific requirements on broad-based preventive awareness programs, training and support for parents and caregivers, inclusive education in mainstream schools and training of relevant professionals.ConclusionComprehensive and coordinated prevention and management programs guided by a specific policy could improve the prevention and management of FASD. Policy formulation demonstrates commitment from the government, highlights the importance of the condition, and elaborates on context-specific prevention and management protocols.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6126-x) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Exploring service providers’ perspectives on the prevention and management of fetal alcohol spectrum disorders in South Africa: a qualitative study

et al. 2018

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“…These results were the catalyst for community members and health and education professionals to identify and implement a culturally appropriate intervention to improve the lives of affected children. A therapy and support program was consequently adapted and embedded in local schools and results of this program are due in 2018 41 …”

Section: Resultsmentioning

confidence: 99%

The Marulu Strategy 2008–2012: overcoming Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley

Fitzpatrick

Oscar

Carter³

et al. 2017

Australian and New Zealand Journal of Public Health

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Objective: Aboriginal leaders concerned about high rates of Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley, remote north-western Australia, introduced restrictions on access to take-away full-strength alcohol. Following this, Aboriginal leaders engaged strategic partners in a broader strategy to address FASD in the region. The aim of this study was to develop and implement a community-led, researcher-supported, FASD strategy. Methods:A review of literature focusing on community-led FASD strategies identified key components that informed the Marulu FASD strategy. These included strategy ownership, leadership, and governance by participating communities, and a research framework.Results: Community meetings and workshops led to the development of The Marulu FASD Strategy (2008). Feasibility and community consent to conduct a FASD prevalence study (the Lililwan Project) was confirmed, and implementation was progressed (2010)(2011)(2012)(2013). Concurrent FASD prevention activities were conducted. In 2012, the Marulu FASD Unit was established within a local Aboriginal organisation to sustain and coordinate ongoing strategy activities.Conclusions: Community control of public health initiatives can be achieved when Aboriginal communities prioritise issues of significant concern, and engage strategic partners to overcome them. Implications for public health:The Marulu Strategy forms a template for action to address FASD and other public health issues in Aboriginal communities in Australia and internationally.

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“…This included consultation with Aboriginal Elders, community leaders and representatives from health and education. 47 …”

Section: Methods and Analysismentioning

confidence: 99%

“…An initial battery of outcome measures was trialled and revised for the broader study, based on feedback from teachers and parent/caregivers, and following analysis of pilot study data. 47 Principals and community members from eight of the other nine primary schools agreed for their school to be a part of the larger trial.…”

Section: Methods and Analysismentioning

confidence: 99%

“…The training was developed in consultation with the Alert Program developers, local occupational therapists and feedback from the implementation of teacher training during the pilot study. 47 Teachers, AIEOs, education assistants (EAs) and school leaders participated in a 1-day training session prior to Alert Program implementation, This workshop introduced participants to Alert Program concepts, curriculum guide and resources to be delivered to their students. Participants viewed modules one and two from the Alert Program on-line leaders’ training which covered the first four of eight Alert Program key concepts.…”

Section: Methods and Analysismentioning

confidence: 99%

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Study protocol for a self-controlled cluster randomised trial of the Alert Program to improve self-regulation and executive function in Australian Aboriginal children with fetal alcohol spectrum disorder

et al. 2018

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IntroductionWhile research highlights the benefits of early diagnosis and intervention for children with fetal alcohol spectrum disorders (FASD), there are limited data documenting effective interventions for Australian children living in remote communities.Methods and analysisThis self-controlled cluster randomised trial is evaluating the effectiveness of an 8-week Alert Program school curriculum for improving self-regulation and executive function in children living in remote Australian Aboriginal communities. Children in grades 1–6 attending any of the eight participating schools across the Fitzroy Valley in remote North-West Australia (N ≈ 363) were invited to participate. Each school was assigned to one of four clusters with clusters randomly assigned to receive the intervention at one of four time points. Clusters two, three and four had extended control conditions where students received regular schooling before later receiving the intervention. Trained classroom teachers delivered the Alert Program to students in discrete, weekly, 1-hour lessons. Student outcomes were assessed at three time points. For the intervention condition, data collection occurred 2 weeks immediately before and after the intervention, with a follow-up 8 weeks later. For control conditions in clusters two to four, the control data collection matched that of the data collection for the intervention condition in the preceding cluster. The primary outcome is change in self-regulation. FASD diagnoses will be determined via medical record review after the completion of data collection. The results will be analysed using generalised linear mixed modelling and reported in accordance with Consolidated Standards of Reporting Trials (CONSORT) guidelines.Ethics and disseminationEthical approval was obtained from the University of Western Australia (WA) (RA/4/1/7234), WA Aboriginal Health Ethics Committee (601) and WA Country Health Service (2015:04). The Kimberley Aboriginal Health Planning Forum Research Sub-Committee and WA Department of Education also provided approval. The results will be disseminated through peer-reviewed journals, conference presentations, the media and at forums.Trial registration numberACTRN12615000733572; Pre-results.

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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: 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.

Cited by 18 publications

References 24 publications

Exploring service providers’ perspectives on the prevention and management of fetal alcohol spectrum disorders in South Africa: a qualitative study

Exploring service providers’ perspectives on the prevention and management of fetal alcohol spectrum disorders in South Africa: a qualitative study

The Marulu Strategy 2008–2012: overcoming Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley

Study protocol for a self-controlled cluster randomised trial of the Alert Program to improve self-regulation and executive function in Australian Aboriginal children with fetal alcohol spectrum disorder

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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: 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.

Cited by 18 publications

References 24 publications

Exploring service providers’ perspectives on the prevention and management of fetal alcohol spectrum disorders in South Africa: a qualitative study

Exploring service providers’ perspectives on the prevention and management of fetal alcohol spectrum disorders in South Africa: a qualitative study

The Marulu Strategy 2008–2012: overcoming Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley

Study protocol for a self-controlled cluster randomised trial of the Alert Program to improve self-regulation and executive function in Australian Aboriginal children with fetal alcohol spectrum disorder

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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