https://orcid.org/0000-0002-1202-9172
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ABSTRACT
Studies in north-western Australia Aboriginal communities identified executive functioning and behavioural regulation as significant issues for children. Exposure to alcohol prenatally and adverse childhood experiences are known risk factors for impaired self-regulation and executive function, these risk factors being present in remote communities. In response, a partnership was initiated to trial a teacher-delivered self-regulation intervention based on the Alert Program®. While student outcomes were assessed, this paper describes the implementation and impact of the intervention on teachers through the five dimensions of the RE-AIM framework (Reach, Efficacy, Adoption, Implementation, Maintenance). Trained classroom teachers (n = 29) delivered eight Alert Program® lessons to students over 8- weeks. Impact and implementation outcomes were assessed through teacher training and student lesson attendance data, and pre-training and post-intervention teacher questionnaires. Data were analysed using paired-samples t-tests and descriptive statistics. Eighty-one to 100% of prescribed lessons were implemented and teacher understanding of self-regulation and the Alert Program® improved significantly following the intervention (n = 14, p ≤ .001). Most teachers (88%) reported changing their teaching and behaviour management practices because of the intervention and agreed there were benefits in teaching the Alert Program® to students in a region with high reported rates of foetal alcohol spectrum disorder and self-regulation impairment.
Acknowledgments
The authors thank the Fitzroy Valley students, families, school staff and communities who were involved in and supported this work. We acknowledge the contribution of Alert Program® study team chief investigators and project team members; Professor Jane Latimer, Professor Karen Edmond, Glenn Pearson, Maureen Carter, Professor Branko Celler, Doctor Tracy Jirikowic, Doctor Heather Carmichael-Olson, Professor Jane Valentine, Emma Douglas, Tracy McRae, Gayle Segar, Jacinta Freeman and Kaashifah Bruce. We thank Sue Cherel (lead community researcher) and the team of Fitzroy Valley Aboriginal community researchers. We are also grateful to the volunteers, students and Alcohol and Pregnancy & FASD Research Team colleagues who supported overall data collection and entry. The authors also acknowledge WA Health, WA Department of Education, Nindilingarri Cultural Health Service and Marninwarntikura Fitzroy Women’s Resource Centre for their project support.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes
1. Marulu is a Bunuba word meaning ‘precious, worth nurturing.
2. Lililwan is a Kimberley Kriol word meaning ‘all the little ones’.
Additional information
Funding
Notes on contributors
Bree Wagner
Bree Wagner, Senior Research Officer, PhD Candidate, Registered Teacher. Coordinates the Alert Program® research project and has worked as a teacher and deputy principal in remote Western Australian primary schools.
Donna Cross
Donna Cross, EdD, Professor School of Medicine, Dentistry and Health Science, The University of Western Australia and the Telethon Kids Institute. Research interests include school health promotion, social and emotional development.
Emma Adams
Emma Adams, MPH, Research Officer. Has interests in population health and applied statistics, worked on foetal alcohol spectrum disorder prevention and management research projects in Western Australia.
Martyn Symons
Martyn Symons, PhD, Postdoctoral Researcher. Has a background in Cognitive Science, machine learning, and alcohol research and is currently focused on studying the diagnosis and prevention of FASD.
Trevor G. Mazzucchelli
Trevor G. Mazzucchelli, PhD, Senior Lecturer of Clinical Psychology. His research interests include developmental disorders, self-management, and how individuals and families can achieve optimal levels of functioning under both stressful and normal circumstances.
Rochelle Watkins
Rochelle Watkins, PhD, Senior Research Fellow, has a background in physiotherapy and population health, and studies foetal alcohol spectrum disorder epidemiology, management and prevention in Australia
Edie Wright
Edie Wright, Edith Wright, Teacher, Principal, Regional Manager Education, Director Magabala Books, Honorary Fellowship Australian Council Education Leadership, Author. Lead Aboriginal education in public schools in Kimberley region of WA for thirty years and currently writing second book.
Jane Latimer
Jane Latimer, PhD, Professor in the School of Public Health, Senior Principal Research Fellow. Since 2009 she has worked with Indigenous leaders in north Western Australia to determine the burden of FASD and to evaluate promising solutions.
Jonathan Carapetis
Jonathan Carapetis, MBBS PhD. Paediatrician and Director of Telethon Kids Institute. Research interests include Aboriginal child health, especially rheumatic heart disease, and development.
John Boulton
John Boulton, MB ChB MD FRACP Emeritus Professor of Paediatrics. The focus of his work is on the intersection of the bio-medical determinants of children’s health and the categorically different dimensions of Aboriginal parenting that confound Western public health strategies.
James P. Fitzpatrick
James P. Fitzpatrick, PhD, MBBS, FRACP, B.Sc, Adjunct Professor of Medicine, Paediatrician. Research interests include clinical interventions and translational research in FASD prevention, diagnosis and management, with a focus on Indigenous Australian communities.