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Objective: Immigrant health discussions often focus on acculturation and omit discussions on historical events that may underlie health differences among immigrant older adults. This paper provides a historical overview of immigration policy and flows to the U.S. and examines insurance access and health difficulties by sending country. Methods: We analyzed the "Immigrants Admitted to the United States, Fiscal Years 1972–2000" and 2015–2019 American Community Survey datasets to examine the number of admitted immigrants, sociodemographic profiles for current immigrant older adults, and the predicted probabilities of health insurance access and health difficulties. Results: Our results highlight alignment of immigration flows with immigration legislation and vast heterogeneity in migration, health, and healthcare access of immigrants by sending country. Discussion/Implications: Public health practitioners must consider how historical events and social factors contribute to the healthcare access and health of immigrant populations, as demographic shifts will require interventions that promote equitable healthy aging. [ABSTRACT FROM AUTHOR]

Greater attention is being paid to issues surrounding end-of-life care for aging adults with developmental disabilities. The purpose of this qualitative study was to explore the end-of-life experiences of two aging adults with developmental disabilities and life-limiting serious illnesses who received care in settings in the United States. Using a comparative case study design, data from three sources (records, staff, surrogates) were collected sequentially and triangulated via within and cross-case analyses. Although the setting and design limit the generalizability of these findings, the feasibility of delivering high quality care to adults with developmental disabilities as they age and experience terminal illnesses is supported. Insights are presented regarding how nurses can address barriers by adapting policies and practices to accommodate the distinct needs that arise as people with developmental disabilities age, become seriously ill, and reach life's end. [ABSTRACT FROM AUTHOR]

African Americans experience higher incidence and prevalence of Alzheimer's disease (AD). Yet, they continue to be underrepresented in AD research, limiting the ability to generalize findings to the increasingly diverse US population. To reduce AD disparities, targeted efforts are needed to increase the representation of African Americans in AD research. This mini review identified evidence-based strategies that increased research participation among older African Americans. Four recruitment strategies emerged from eight published peer-reviewed studies that directly evaluated the effectiveness of strategies aimed at increasing the number of African American participants in Alzheimer's research. The strategies include community outreach and education, face-to-face discussions, remote access, and referral and partnership with local organizations. Across different locations, these strategies increased the number of African Americans enrolled into AD research, the number of people that signed up to donate their brains for AD research upon death, and the knowledge and perception of AD in the communities. Targeted efforts are effective in increasing AD research participation among older African Americans, especially when combined with approaches that emphasize transparency and mutual trust and involve the community as stakeholders in the research process. [ABSTRACT FROM AUTHOR]

This study examines caregiver networks, including size, composition, and stability, and their associations with the likelihood of hospitalization and skilled-nursing facility (SNF) admissions. Data from the National Health and Aging Trends Study linked to Center for Medicare and Medicaid Services data were analyzed for 3855 older adults across five survey waves. Generalized estimating equation models assessed the associations. The findings indicate each additional paid caregiver was associated with higher adjusted risk ratios (aRR) for hospitalization (aRR = 1.24, 95% CI 1.10–1.41) and SNF admission (aRR = 1.28, 95% CI 1.06–1.54) among care recipients, a pattern that is also observed with the addition of unpaid caregivers (hospitalization: aRR = 1.13, 95% CI 1.06–1.20; SNF: aRR = 1.12, 95% CI 1.02–1.23). These results suggest that policies and approaches to enhance the quality and coordination of caregivers may be warranted to support improved outcomes for care recipients. [ABSTRACT FROM AUTHOR]

Greater attention is being paid to issues surrounding end-of-life care for aging adults with developmental disabilities. The purpose of this qualitative study was to explore the end-of-life experiences of two aging adults with developmental disabilities and life-limiting serious illnesses who received care in settings in the United States. Using a comparative case study design, data from three sources (records, staff, surrogates) were collected sequentially and triangulated via within and cross-case analyses. Although the setting and design limit the generalizability of these findings, the feasibility of delivering high quality care to adults with developmental disabilities as they age and experience terminal illnesses is supported. Insights are presented regarding how nurses can address barriers by adapting policies and practices to accommodate the distinct needs that arise as people with developmental disabilities age, become seriously ill, and reach life's end. [ABSTRACT FROM AUTHOR]

Data from the Vietnamese Aging and Care Survey (VACS) showed the high prevalence of disability, depressive symptoms, and cognitive impairment in older Vietnamese immigrants and refugees. We proposed a Community-Engaged Dementia Education Program to examine the Houston Vietnamese American community's literacy on dementia and develop a one-pager educational material. This is a cross-sectional, qualitative study (interviews and focus groups) using the Cultural Exchange Model as a conceptual framework. We interviewed fourteen Vietnamese key informants and assessed the community's knowledge of dementia based on Edwards' 9-stage Community Readiness Model. The community's low literacy on dementia (Stages 2–3: Denial/resistance to vague awareness) was revealed. Approaches to introducing dementia conversations to the community and what to include in the one-pager were discussed. Based on the key informants' insight, we developed a dementia one-pager tailored to the community by using lay language with a representative image of the target population, indicating warning signs of dementia, and encouraging them to see their doctors for cognitive check-ups. The plan for the next steps includes utilizing the local ethnic media, collaborating with the existing pillars of the Cultural Exchange model, leveraging the university students' learning opportunities, and disseminating the culturally and linguistically tailored one-pager. [ABSTRACT FROM AUTHOR]

This article introduces the special issue on Aging and Resilience in the Americas: Mexico and the United States. The article overviews the role that the annual International Conference on Aging in the Americas (ICAA) has played in the development of scholarship on aging of Latinos in the United States and older persons in Latin America and the Caribbean. A brief overview of the aging literature reveals a growing interest on the resiliency of older Latino and Latin American populations in the United States and more broadly the Americas. The article provides a short description of each of the five articles included in this special issue [ABSTRACT FROM AUTHOR]

Background: Studies show conflicting evidence on the association of age and occupational injury in agriculture, and few studies have addressed the effect of age on work-related chronic conditions or preventive practices among farmers. Methods: We examined the probability of injury, work-related stress, musculoskeletal symptoms (MSS), and preventive practices for MSS as a function of aging using surveillance data of 7,711 farm and ranch operators in the central United States. Findings: Segmented regression analyses of men (85% of sample) indicated that the probability of all four outcomes increased up to a certain age and then decreased; the changepoints in years of age being 59.6 for injury, 55.4 for work-related stress, 59.6 for MSS, and 67.9 for MSS preventive practices. Female operators had an increasing trend for stress up to age 29.7, while they showed no changepoints across their age spectrum in the proportion of injury, MSS, and prevention techniques. Conclusion/Application to Practice: These findings emphasize the need for preventive efforts particularly among younger and middle-aged farmers and ranchers, and the need to modify work duties to match work abilities at older ages. [ABSTRACT FROM AUTHOR]

Objectives: To examine the need for and arrangements pertaining to personal care assistance among individuals 65 and older, and how life stage at migration impacts nativity differences in aging-related care. Methods: Using data from the Survey of Income and Program Participation (2001, 2004, and 2008), I examine the odds of needing care assistance, who provides care assistance, and the duration of time care assistance is needed, comparing U.S.-born individuals to migrants who arrived before age 50 ("earlier-life migrants") and those who arrived after age 50 ("later-life migrants"). Results: While earlier-life migrants showed similar patterns to U.S.-born, later-life migrants showed higher care needs, were more likely to receive care from an adult child, and were particularly likely to need care for longer durations compared to U.S.-born. Discussion: Aging later-life migrants have strikingly distinct care needs and arrangements, with implications for individual and family well-being, especially considering their barriers to public support. [ABSTRACT FROM AUTHOR]

Increasing numbers of older workers continue to work after being eligible to claim a state pension, yet little is known about the quality of these jobs. We examine how psychosocial and physical job quality as well as job satisfaction vary over the late career in three contrasting national settings: Sweden, Japan and the United States. Analyses using random effects modelling drew on data from the Swedish Longitudinal Occupational Survey of Health (n = 13,936-15,520), Japanese Study of Ageing and Retirement (n = 3704) and the Health and Retirement Study (n = 6239 and 8002). Age was modelled with spline functions in which two knots were placed at ages indicating eligibility for pensions claiming or mandatory retirement. In each country, post-pensionable-age jobs were generally less stressful, freer and more satisfying than jobs held by younger workers, results that held irrespective of gender or education level. [ABSTRACT FROM AUTHOR]

The National Health Interview Survey (NHIS) data on self-reported trouble hearing and the use of hearing aids were examined for the 12 recent surveys from 2007 to 2018 for adults from 18 to 85+ years of age. The aggregate dataset for all years included data from 357,714 adult respondents. Sample size for annual data ranged from 22,058 (2008) to 36,798 (2014). The prevalence of self-reported trouble hearing and hearing aid use, both current use and ever-using hearing aids, are reported for males and females for each age decade. Measures of unmet hearing healthcare (HHC) need were derived from estimates of the prevalence of hearing aid use among those with self-reported trouble hearing. Logistic-regression analyses identified variables affecting the odds of having self-reported trouble hearing, of using or rejecting hearing aids, and of having unmet HHC needs. The results largely corroborate and extend the findings of recent analyses of data from the National Health and Nutrition Examination Survey (NHANES) for a similar period (2011-2020). Overall, for males, 18.5% (95% CI [18.2%-18.8%]) had self-reported trouble hearing and 76.6% [76.0%-77.2%] of these individuals had never used hearing aids and, for females 13.1% [12.9%-13.4%] had trouble hearing and 79.5% [78.9%-80.1%] of these individuals had never used hearing aids. Unmet HHC needs are highly prevalent in the United States and have been so for many years. [ABSTRACT FROM AUTHOR]

Objectives: Age-associated accelerated declines in physical health vary across individuals, and researchers have suggested that individual differences in decline may vary as a function of stressors. The relation of one such stressor, negative social exchanges, to accelerated declines in self-rated health is investigated. Method: Participants are from a 2-year, 5-wave, national, longitudinal study of social relationships among older adults. Growth curve analyses are used to examine the relation of negative and positive social exchanges to accelerated changes in self-rated health, controlling for age, sex, race/ethnicity, education, and depressive symptoms. Results: Individuals reporting more frequent negative social exchanges showed significantly accelerated declines in physical health. Positive social exchanges were not related to linear or accelerated declines in self-rated health over time. Discussion: The association between negative social exchanges and accelerated deterioration in self-rated health provides general support for hypotheses that interpersonal stressors play an important role age-related physical health decline. [ABSTRACT FROM AUTHOR]

While the overall United States prison population has decreased over the last 10 years, the number of sentenced individuals above the age of 50 nearly doubled during the same period. The focus of this study, the pains of imprisonment experienced by the aging, is an under-researched area in the prison literature. Results from a sample of 134 male participants of True Grit, a structured living program for older prisoners, indicate strong agreement among sexagenarians, among septuagenarians, and between them. Previous studies of the pains of imprisonment found similar evaluations of the most and least difficult aspects of incarceration. While different instruments were used, collectively these studies suggest some commonality in the greatest hardships and least problematic aspects of incarceration. Policy implications derived from the present research are considered. [ABSTRACT FROM AUTHOR]

This special issue of the Journal of Aging and Health honors the memory of James Jackson by elevating his many research contributions to the physical and mental health of older Black Americans. The articles focus on the central problems and questions that James Jackson addressed throughout his illustrious career. All articles in the special issue focus on older Black Americans and include at least one of the following elements: (1) articles based on the National Survey of American Life, the data set for which James Jackson was the Principal Investigator; (2) articles that utilize the Environmental Affordances Model which was developed by James Jackson; (3) articles that include the Everyday Discrimination scale which was originally published by David Williams, James Jackson, and colleagues; (4) and articles based on the Health and Retirement Study (HRS), the data set for which James Jackson served as Editor for a special issue of The Gerontologist. [ABSTRACT FROM AUTHOR]

The U.S. population of older adults living with dementia is projected to double by 2060. They rely on over 16 million family and unpaid caregivers to provide for their increasingly complex needs and care transitions. Caregivers frequently feel underprepared and without adequate support or access to resources. This systematic review seeks to identify the needs of family and unpaid caregivers of older adults living with dementia across various care settings in the U.S. A systematic search was conducted to identify articles pertaining to the needs of caregivers of older adults living with dementia. The data extraction tool was developed using aspects from the Care Transitions Framework and the Family Caregiver Alliance. Data were organized based on 3 domains of caregiver needs and the care setting(s) of the older adults living with dementia and their caregivers. A total of 31 articles were eligible for inclusion. The majority met the MMAT screening criteria, but more than half only met 2 or less of the 5 quality criteria. Caregivers' needs were identified in the care settings of home/community-residing, assisted living, long-term care, skilled nursing, and memory care. Most articles either did not specify a care setting or included more than 1 and did not report the findings separately. Caregivers in each care setting, except memory care, identified needs in all 3 of the following domains: (1) social support—formal and informal, (2) confidence, competence, and strengths in the caregiving role, and (3) values and preferences. [ABSTRACT FROM AUTHOR]

Objectives: This study examines how the patterns of life partner concordance on preventive health service uptake vary by a partner's previous behavioral history and between genders. Method: This study uses 2008 and 2012 waves of Health and Retirement Study (HRS), a nationally representative sample of U.S. aging population, to examine one's decision to receive a preventive service as a function of the partner's decision changes over time (N = 2,680). Results: Life partner concordance on preventive service use is different by the partner's previous use history and gender. Positive partner preventive engagement showed greater association than negative ones. Women are more responsive to the positive health behaviors (of their partners), and men are more sensitive to the negative partner health behaviors. Conclusion: The asymmetric partner concordance by gender and the partner's previous usage experience provide implications to develop efficient and culturally acceptable interventions to increase the uptake of preventive health services. [ABSTRACT FROM AUTHOR]

Sociologists have shown that the relationships people establish between moral orientations and market practices vary considerably across historical, geographic, and institutional contexts. Less attention has been paid to situational variation in how the same actors moralize different economic goals, especially in their workplace. This article offers an account of situational variation by theorizing the implications of the ambiguity of moral values for economic activity. I draw on the case of a post-acute care unit, where reimbursement policies create the contradictory demands of discharging elderly patients quickly while ensuring their safety to avoid re-hospitalization. Using ethnography and interviews, I show that the same actors switched between different normative evaluations of "independent aging" to legitimize divergent organizational goals. A shared understanding of autonomy as synonymous with "home" moralized the organizational mission of discharging patients off the unit. Expectations that elderly people attain independence by acknowledging need for assistance moralized the extension of services. Conversely, interpreting independence as a constellation of duties to be self-reliant moralized practices that lead to fast discharge. Based on these findings, I develop a framework of moral polysemy to analyze ambiguity as a resource for cooperation in organizations and a tool to expand understanding of moral economies. [ABSTRACT FROM AUTHOR]

The low uptake of private long-term care insurance (LTCI) by the elderly in the United States, despite visible risks, has left economists puzzled. Prior studies have hypothesized that home equity can be a substitute for LTCI and hence may partly explain the low uptake. We test this hypothesis empirically. We utilize exogenous variation in house prices at the level of the metropolitan statistical area (MSA) as an instrument for home equity for individuals residing in that MSA and data from the Health and Retirement Study. In the most robust specifications, we find no evidence that the elderly change their decision on LTCI based on variation in their home equity, and even specifications requiring stronger identification assumptions imply only small effect magnitudes. Home equity as a substitute for LTCI does not appear to be a major contributing factor to low LTCI take up. [ABSTRACT FROM AUTHOR]

Antiretroviral therapy (ART) is the primary treatment for HIV, and adherence to it is crucial to addressing health disparities. Approximately half of individuals in the United States living with HIV are African Americans, and those over 45 years of age are more likely to die early from HIV/AIDS than their White counterparts. This mixedmethod pilot study evaluated the feasibility of a text-based mobile phone intervention designed to improve ART adherence among older African Americans with HIV. Feasibility was assessed via implementation, participant adherence, acceptability, and satisfaction, as well as short-term impact on medication adherence, adherence-related self-efficacy, and positive affect. The intervention utilized pill reminder, motivational, and health educational texts. Participants (N = 21) ranged in age from 50 to 68 years. Outcomes were evaluated via quantitative results from self-report measures and qualitative data from four focus groups. There was no attrition in participation. After 8 weeks, participants reported statistically significant improvements in medication adherence, but not in self-efficacy or affect scores. Qualitative findings highlight the psychologically supportive potential of the intervention, challenges to adherence, as well as suggestions for improvement. The study demonstrates that a text messaging intervention may be feasible for older African Americans with HIV, and helpful in supporting ART adherence. [ABSTRACT FROM AUTHOR]

The purpose of this article is to consider the promise and problems of the globalization of research for nurses and other healthcare professionals. Over the past decade, there has been an impressive increase in research activity in many regions of the world, such as in several of the Asian countries. This increasing capacity to conduct research and create innovations has great promise for shared health, prosperity, and well-being, but it also has some significant problems and limitations that are often not reported. One area of research that has drawn considerable international research attention is aging and longevity. In the United States, there is much to learn from the work of international colleagues in terms of clinical application; it is unclear how generalizable the findings are or, in other words, what may be lost in translation. [ABSTRACT FROM AUTHOR]

As one ages, the chance of acquiring functional limitations increases dramatically. Thus, a remarkably high proportion of older workers will likely qualify for workplace accommodations. The current study aimed to gain an understanding of subgroups of older workers who were less likely to request and receive accommodations, associations of psychosocial factors (i.e., workplace supports, employees’ knowledge of the Americans With Disabilities Act [ADA] and accommodations, and whether an individual has a work goal) with requesting and receiving accommodations, and differences on these psychosocial factors within various demographic subgroups of older workers. Two hundred thirty-one individuals 50 years and older recruited from multiple national organizations and rehabilitation agencies participated in this study through an online survey. The study found that the psychosocial factors were positively associated with requesting and receiving accommodations. In addition, participants who were less likely to request and receive accommodations reported lower scores in the psychosocial factors. Practical implications for rehabilitation counselors and further research are discussed. [ABSTRACT FROM AUTHOR]

Objective: This research explores whether physical neighborhood disorder or perceived social cohesion is associated with participation in social activities among older Americans (age 65+). Method: Using the first wave of the National Health & Aging Trends Study (NHATS; N = 6,383), a series of logistic regression models were created to assess the odds of participation. Results: Low social cohesion was associated with decreased odds of visiting friends and family (odds ratio [OR] = 0.65; 95% confidence interval [CI] = [0.52, 0.82]) and participating in organizations (OR = 0.68; 95% CI = [0.53, 0.88]). Presence of neighborhood disorder was associated with decreased odds of visiting friends and family (OR = 0.62; 95% CI = [0.47, 0.82]), participating in organizations (OR = 0.66; 95% CI = [0.48, 0.89]), and going out for enjoyment (OR = 0.68; 95% CI = [0.53, 0.86]). Physical capacity and activity value moderated the relationship between neighborhood disorder/cohesion and attending religious services. Discussion: Improving neighborhood disorder and social cohesion may increase social participation among older adults. [ABSTRACT FROM AUTHOR]

The current studies examined the hypothesis that maturity fears are increasing among undergraduate men and women from the United States over time. Study 1 used a time-lag method to assess generational effects of maturity fears among a large sample (n = 3291) of undergraduate men and women assessed in 1982, 1992, 2002, and 2012. Results revealed that both men and women reported Significantly higher rates of maturity fears across time. Study 2 replicated these findings, and used a more restricted time frame to more closely examine the rate of change. Undergraduate women (n = 673) were assessed in 2001, 2003, 2009, and 2012. Maturity fears were again found to increase from 2001 to 2012. Recent cohorts of emerging adults seem more reluctant to mature than previous cohorts. Many contributing factors may be at play, including challenging economic times, social pressures to remain youthful, and/or internal fears of assuming increased responsibility. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including immigration, family, and macro and micro-economic changes and its impact on the quality of community life.

Objective: To characterize the health status of older island Puerto Ricans, a segment of the U.S. population that has been largely overlooked in aging research. Method: Data from the 2002 Puerto Rican Elderly Health Conditions Project and the 2002 Health and Retirement Study are used to examine differences in disease, disability, and self-rated health among island Puerto Ricans and the mainland U.S.-born older adult population. Differences are further examined by gender. Results: Island Puerto Ricans were less likely to have heart disease, stroke, lung disease, cancer, activities of daily living (ADL) limitations, and poor self-rated health, but more likely to have hypertension and diabetes. Island Puerto Rican women had worse health relative to island Puerto Rican men. Discussion: Recent challenges in the funding and provision of health care in Puerto Rico are worrisome given the large number of aging island adults, many of whom have hypertension and diabetes, two conditions that require long-term medical care. [ABSTRACT FROM AUTHOR]

Using a national survey of US local governments, we explore the drivers of planning and service delivery for older adults. Our regression models find that planning for aging and elder engagement are the most influential factors explaining the level of community services for elders. Services are lower in less dense suburban and rural communities, and market-based services are lower in communities with more senior poverty. This creates two challenges for planners: to help generate a market response for aging services, and to articulate the link between the built environment and services so communities that lack supportive physical environments can become better places to age. [ABSTRACT FROM AUTHOR]

Research on the gender division of family labor largely focuses on housework and childcare in spousal couples. This article advances scholarship by examining the gender division of elderly parent care in sibling groups. Using the Health and Retirement Study, a nationally representative survey of elderly Americans, I find that caregiving to elderly parents varies not only by an adult child's own gender, but also by the gender of the siblings with whom caregiving is shared and by the gender of the parent to whom care is provided. The salience of an adult child's gender manifests in two primary ways: not only do daughters provide more care than do sons to their elderly parents, but daughters' caregiving is also more elastic with respect to their own and their parents' attributes than is sons' caregiving. With respect to the gender of the siblings, sons provide relatively less care if they have sisters, whereas daughters provide relatively more care if they have brothers. With respect to the gender of the parent, sons provide relatively more care to fathers, and daughters provide relatively more care to mothers. Finally, analyses did not reveal changes over time. [ABSTRACT FROM AUTHOR]

Blacks are especially hard hit by cognitive impairment at older ages compared to whites. Here, we take advantage of the Health and Retirement Study (1998-2010) to assess how this racial divide in cognitive impairment is associated with the racial stratification of life course exposures and resources over a 12-year period among 8,946 non-Hispanic whites and blacks ages 65 and older in 1998. We find that blacks suffer from a higher risk of moderate/severe cognitive impairment at baseline and during the follow-up. Blacks are also more likely to report childhood adversity and to have grown up in the segregated South, and these early-life adversities put blacks at a significantly higher risk of cognitive impairment. Adulthood socioeconomic status is strongly associated with the risk of cognitive impairment, net of childhood conditions. However, racial disparities in cognitive impairment, though substantially reduced, are not eliminated when controlling for these life course factors. [ABSTRACT FROM AUTHOR]

We concatenate 28 years of historical depressive symptoms data from a longitudinal cohort study of U.S. gay men who are now midlife and older (n = 312), with newly collected survey data to analyze trajectories of depressive symptomatology over time and their impact on associations between current stress and depressive symptoms. Symptoms are high over time, on average, and follow multiple trajectories. Aging-related stress, persistent life-course sexual minority stress, and increasing sexual minority stress are positively associated with depressive symptoms, net of symptom trajectories. Men who had experienced elevated and increasing trajectories of depressive symptoms are less susceptible to the damaging effects of aging-related stress than those who experienced a decrease in symptoms over time. Intervention efforts aimed at assisting gay men as they age should take into account life-course depressive symptom histories to appropriately contextualize the health effects of current social stressors. [ABSTRACT FROM AUTHOR]

The recent recession constitutes one of the macro forces that may have influenced workers’ retirement plans. We evaluate a multilevel model that addresses the influence of macro-, meso-, and micro-level factors on retirement plans, changes in these plans, and expected retirement age. Using data from Waves 8 and 9 of the Health and Retirement Study (N = 2,618), we find that individuals with defined benefit plans are more prone to change toward plans to stop work before the stock market declined, whereas the opposite trend holds for those without pensions. Debts, ability to reduce work hours, and firm unionization also influenced retirement plans. Findings suggest retirement planning education may be particularly important for workers without defined pensions, especially in times of economic volatility. [ABSTRACT FROM PUBLISHER]

Antiretroviral therapy (ART) is the primary treatment for HIV, and adherence to it is crucial to addressing health disparities. Approximately half of individuals in the United States living with HIV are African Americans, and those over 45 years of age are more likely to die early from HIV/AIDS than their White counterparts. This mixed-method pilot study evaluated the feasibility of a text-based mobile phone intervention designed to improve ART adherence among older African Americans with HIV. Feasibility was assessed via implementation, participant adherence, acceptability, and satisfaction, as well as short-term impact on medication adherence, adherence-related self-efficacy, and positive affect. The intervention utilized pill reminder, motivational, and health educational texts. Participants (N = 21) ranged in age from 50 to 68 years. Outcomes were evaluated via quantitative results from self-report measures and qualitative data from four focus groups. There was no attrition in participation. After 8 weeks, participants reported statistically significant improvements in medication adherence, but not in self-efficacy or affect scores. Qualitative findings highlight the psychologically supportive potential of the intervention, challenges to adherence, as well as suggestions for improvement. The study demonstrates that a text messaging intervention may be feasible for older African Americans with HIV, and helpful in supporting ART adherence. [ABSTRACT FROM AUTHOR]