{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T04:27:32Z","timestamp":1786595252991,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["CIN 13\u2010410"],"award-info":[{"award-number":["CIN 13\u2010410"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG028716"],"award-info":[{"award-number":["P30AG028716"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["U54 TR0001628"],"award-info":[{"award-number":["U54 TR0001628"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002553"],"award-info":[{"award-number":["UL1TR002553"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older, rural adults face compounded barriers to participating in research, and existing frameworks that guide study design to improve the recruitment and retention of older adults, such as the 5Ts Framework, require adaptation to address them. Older, rural Veterans are one such underrepresented population. Drawing on the expertise of multiple research stakeholders within the VA Health Care System, this effort aimed to develop preliminary insights for refining the framework to better address the intersectional barriers this population faces.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A series of facilitated listening sessions with three groups: VA health services and clinical research investigators who oversee study design, research staff responsible for recruitment and data collection, and Veterans and caregivers engaged with a local research center. Sessions were structured around participants' experiences, challenges, and strategies encountered in their own work related to conducting research with older, rural Veterans. Following all sessions, we used an iterative approach to synthesize findings, identify key recruitment and retention challenges, and map observations onto the relevant elements of the 5Ts Framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants identified numerous barriers to the recruitment and retention of older, rural Veterans. Five themes emerged in which age\u2010related and rurality\u2010related challenges intersected: transportation, the digital divide, institutional barriers, communication and accessibility, and context\u2010specific caregiver engagement shaped by both aging and rurality. While some challenges are addressed within existing 5T recommendations, this work identifies several gaps, such as the need to budget for adaptive equipment in rural settings and for live technical support when studies use virtual platforms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Research investigators, staff, Veterans, and caregivers identified several cross\u2010cutting challenges that are important in the recruitment and retention of older rural Veterans in research. The adaptations proposed here demonstrate that the 5Ts Framework can extend to intersectional aging populations, providing a model for broader representation in research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70658","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T03:37:47Z","timestamp":1786592267000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Barriers to Research Participation Among Older Rural Veterans: Early Insights to Strengthen Frameworks for Age\u2010Inclusive Research"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6912-7315","authenticated-orcid":false,"given":"Justine","family":"Seidenfeld","sequence":"first","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) Durham VA Health Care System  Durham North Carolina USA"},{"name":"Department of Emergency Medicine Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7590-0316","authenticated-orcid":false,"given":"Emily","family":"Franzosa","sequence":"additional","affiliation":[{"name":"Geriatric Research, Education and Clinical Center James J. Peters VA Medical Center  Bronx New York USA"},{"name":"Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Shepherd\u2010Banigan","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) Durham VA Health Care System  Durham North Carolina USA"},{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Duke\u2010Margolis Institute for Health Policy Duke University School of Medicine  Durham North Carolina USA"},{"name":"Mid\u2010Atlantic Mental Illness Research, Education and Clinical Center (MIRECC) Durham VA Health Care System  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Barrett","family":"Bowling","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) Durham VA Health Care System  Durham North Carolina USA"},{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Division of Geriatric Medicine, Department of Medicine Duke University School of Medicine  Durham North Carolina USA"},{"name":"Geriatric Research Education and Clinical Center (GRECC) Durham VA Health Care System  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5732-1927","authenticated-orcid":false,"given":"Nathan A.","family":"Boucher","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) Durham VA Health Care System  Durham North Carolina USA"},{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Duke\u2010Margolis Institute for Health Policy Duke University School of Medicine  Durham North Carolina USA"},{"name":"Division of Geriatric Medicine, Department of Medicine Duke University School of Medicine  Durham North Carolina USA"},{"name":"Sanford School of Public Policy Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"issue":"1","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/jgs.18070","article-title":"Age\u2010Friendly Care in the Veterans Health Administration: Past, Present, and Future","volume":"71","author":"Farrell T. 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