{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:07:58Z","timestamp":1790150878027,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"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>A high prevalence of hypertension is observed among American rural residents. This study aimed to engage rural community members in designing, developing, and preliminarily testing the feasibility of a physical activity (PA)\u2010centered health promotion intervention integrating Fitbit\u2010based activity monitoring and text messaging among rural older adults (50+ years) with hypertension (PACERS). We also tested the feasibility of measuring candidate outcomes for future studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and Setting<\/jats:title>\n                    <jats:p>\n                      Sixteen participants residing in rural South Carolina communities were interviewed to inform the intervention design and development. Over 12\u2009weeks, 10 older adults diagnosed with hypertension with no or low PA participated in preliminary feasibility testing of the intervention and pre\u2010 and post\u2010intervention measurements. Finally, we conducted a post\u2010intervention focus group discussion (FGD,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed health reports, analyzed EHR data, engaged the community to establish health needs, designed and developed PACERS, assessed barriers and facilitators, and tested the preliminary feasibility of the PACERS intervention. Preliminary feasibility was measured by recruitment, retention, fidelity, participants' attendance and acceptability, and candidate outcomes included blood pressure (BP), PA, arterial compliance, cognition, overall health, and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Key pre\u2010design themes included as follows: accessibility, intervention delivery through existing health systems, social isolation, hypertension\u2010cognition relationship, accountability, and perceived positive health impacts. FGD themes included as follows: hypertension\u2010cognition links, financial preparation for retirement and isolation management. Recruitment (90.9%), retention (100%), attendance (93%), adherence (90%), and intervention fidelity (98.5%) rates, as well as average acceptance (4.8\/5), were promising. Some Candidate outcomes showed improvement: quality of life (0.084; 95% CI: 0.022, 0.146;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), systolic BP (\u221234.28; 95% CI: \u221257.77, \u221210.78;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), diastolic BP (\u221219.14; 95% CI: \u221231.68, \u22126.60;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), arterial compliance (\u221215.13; 95% CI: \u221228.00, \u22122.30;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021), and average steps per day (3612; 95% CI: 855, 6370;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides valuable insights into intervention development for older adults in under\u2010resourced settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70726","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:37:41Z","timestamp":1790149061000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Preliminary Feasibility Testing of\n                    <scp>PACERS<\/scp>\n                    , a Physical Activity\u2010Centered Intervention for Rural Older Adults With Hypertension"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9519-7886","authenticated-orcid":false,"given":"Stella T.","family":"Lartey","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, College of Behavioral, Social, and Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moonseong","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, College of Behavioral, Social, and Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel Edward","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, College of Behavioral, Social, and Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya Lee","family":"Staton","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, College of Behavioral, Social, and Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Douglas","family":"Moore","sequence":"additional","affiliation":[{"name":"Self\u2010Regional Healthcare and Abbeville Area Medical Center  Abbeville South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailey","family":"Naples","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, College of Behavioral, Social, and Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Blythe","family":"Bacon","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, College of Behavioral, Social, and Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Skipper","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Powers","sequence":"additional","affiliation":[{"name":"Geriatric Research, Education, and Clinical Center Tennessee Valley Healthcare System  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah F.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, College of Behavioral, Social, and Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa Ann","family":"Gamaldo\u2010Roddy","sequence":"additional","affiliation":[{"name":"Department of Psychology, College of Behavioral, Social, and Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela L.","family":"Jefferson","sequence":"additional","affiliation":[{"name":"Vanderbilt Memory and Alzheimer's Center; 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