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Browsing by Author "Adekoya, Adebusola"

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    Alert Systems for Missing Persons Living with Dementia: From Policy to Implementation
    (University of Waterloo, 2025-08-21) Adekoya, Adebusola
    Background: People living with dementia are at risk of going missing and experiencing serious harm. Alert systems, such as the BC Silver Alert in Canada, Silver Alert in the United States, and Purple Alert in Scotland, use mobile apps or media to notify the public and assist in locating missing persons with dementia. Policies regarding alert systems exist in the United States. Two Canadian provinces mention Silver Alert in Missing Persons Acts, but these legislations are not associated with implementation of these systems. Little is known about how alert systems for older adults are implemented and adopted, specifically in Canada. Objectives: This dissertation examined the development and implementation of alert systems for missing persons with dementia across Canada, Scotland, and the United States through three studies. Study 1 explored user experiences implementing alert systems and related policies, drawing on stories and insights from individuals who went missing, their care partners, and those involved in search efforts. Study 2 examined the conditions surrounding alert system implementation, using the Knowledge-to-Action (KTA) Framework. Study 3 explored multi-level factors influencing implementation of alert systems, guided by the Consolidated Framework for Implementation Research (CFIR). Methods and Results: Using a multiple case study design, data were collected through policy document review, interviews, and focus groups with 40 stakeholders, including people with lived experience, first responders, service providers, policymakers, technology developers, and researchers. Data from the three studies were analyzed using thematic analysis. Study 1 underscored the importance of stakeholder engagement, legislative support, timely police reporting, coordinated search efforts, and public education in implementing alert systems and locating missing persons. The findings also highlighted the emotional impact of missing incidents on people living with dementia and their care partners and challenges such as inaccurate tips, which can delay search efforts. Study 2 findings revealed variability in alert system implementation and related policies and identified individual and organizational barriers, including limited understanding, privacy concerns, alert fatigue, sustainability, and accessibility. Findings from Study 3 identified key factors influencing alert systems implementation across CFIR domains: Intervention Characteristics (relative advantage, evidence strength and quality, cost), Outer Setting (end user needs and resources, cosmopolitanism, external policy and incentives), Inner Setting (culture, available resources), Characteristics of Individuals (knowledge and beliefs about the intervention), and Implementation Process (planning, engaging stakeholders, reflecting and evaluating). Findings from the three studies emphasize the importance of integrated implementation of alert systems that actively engage stakeholders, address contextual factors and challenges, and ensure equitable access for all users. Contributions: This dissertation provides an understanding of how current alert systems and related policies are developed and implemented to locate missing persons with dementia. Effective implementation of alert systems relies on cross-sector collaboration, clear and consistent policy, user-centered design, sustained funding, dementia-specific training and public education, and continuous evaluation. The framework and recommendations proposed in this dissertation offer practical guidance for policy and practice in alert system implementation to reduce the risks associated with going missing and uphold the safety and dignity of people living with dementia. Sustainability of any alert system implementation relies on rigorous and compelling evaluation of impact.