Client Preferences Research Articles

AI-driven robo-advisors on personal financial management and investment strategies

The advent of AI-driven robo-advisors has revolutionized personal financial management and investment strategies. Leveraging sophisticated algorithms and machine learning, these platforms offer personalized financial advice and automated portfolio management with minimal human intervention. By analyzing vast datasets, including market trends, economic indicators, and individual client preferences, robo-advisors can create tailored investment plans that optimize returns and manage risks effectively. This paper explores the transformative impact of AI in democratizing financial advice, enhancing decision-making processes, and making investment management accessible to a broader audience. The integration of AI in robo-advisory services not only improves efficiency but also provides a scalable solution to meet the diverse financial needs of individuals.

Assessment of Factors Affecting Customer Preferences and Customer Satisfaction on Online Shopping Experiences Case of Delhi NCR

This study is on assessment of factors affecting customer preferences and customer satisfaction on online shopping experiences in Delhi NCR. It is mandated to look into the different aspects of e-shopping, from factors that determine the individual preferences, to those that influence satisfaction and some pain points that the customers experience. The objectives of the research are to look into what influences consumers' choice of e-commerce platforms, evaluate and assess the different aspects contributing to customer satisfaction in the online shopping experience, and explore common challenges faced by customers while shopping online. The study offers important insights into the dynamics of e-commerce platforms and consumer preferences through a thorough examination of these goals. A number of factors, such as frequency of purchases, price competition, app use, return policies, and delivery reliability and speed, affect customers' choice of e-commerce platforms. According to the analysis, the majority of users give priority to platforms that provide easy-to-use payment methods including E-payments and Cash on Delivery (COD) (71%). One important feature that stood out was price competitiveness (58%); consumers favored platforms that provided a large selection of products at competitive prices. Customers also emphasized the importance of the user-friendliness of apps, the return policy, and the dependability and timeliness of delivery while choosing e-commerce platforms. The majority of consumers (77%) are satisfied with their online purchasing experiences, according to the study. Customer satisfaction is largely influenced by the usability of websites and mobile apps, the reliability and speed of deliveries, and the correctness and quality of the products. Platforms that provide high-quality products, timely and dependable delivery services, and user-friendly interfaces are highly valued by customers. These elements have a big impact on how satisfied consumers are with e-commerce sites overall. Although consumers are generally satisfied, there are a number of difficulties when they shop online. Common pain points experienced are poor product quality, complicated or nonexistent return processes, worries about payment security, language barriers, and improper item deliveries. These difficulties highlight how critical it is to respond to consumer complaints and improve the online shopping experience by implementing stronger security measures, clear return procedures, and better-quality products. Several recommendations are put out in light of the findings in order to boost e-commerce platform efficacy and raise customer satisfaction. The study further acknowledges limitations, which could affect how broadly the results can be applied, such as its limited sample size and resource limits. In order to offer more thorough insights into the tastes and behaviours of e-commerce customers, future research projects should address these shortcomings. The study concludes by highlighting the multifaceted nature of client preferences and issues in the e-commerce sector. E-commerce platforms may promote stronger client loyalty and drive sustainable growth in the cutthroat online marketplace by comprehending the variables impacting platform choice, improving components contributing to customer satisfaction, and addressing frequent issues experienced by customers.

WhatsApp Versus SMS for 2-Way, Text-Based Follow-Up After Voluntary Medical Male Circumcision in South Africa: Exploration of Messaging Platform Choice.

Telehealth is growing, especially in areas where access to health facilities is difficult. We previously used 2-way texting (2wT) via SMS to improve the quality of postoperative care after voluntary medical male circumcision in South Africa. In this study, we offered males aged 15 years and older WhatsApp or SMS as their message delivery and interaction platform to explore user preferences and behaviors. The objectives of this process evaluation embedded within a larger 2wT expansion trial were to (1) explore 2wT client preferences, including client satisfaction, with WhatsApp or SMS; (2) examine response rates (participation) by SMS and WhatsApp; and (3) gather feedback from the 2wT implementation team on the WhatsApp approach. Males aged 15 years and older undergoing voluntary medical male circumcision in program sites could choose their follow-up approach, selecting 2wT via SMS or WhatsApp or routine care (in-person postoperative visits). The 2wT system provided 1-way educational messages and an open 2-way communication channel between providers and clients. We analyzed quantitative data from the 2wT database on message delivery platforms (WhatsApp vs SMS), response rates, and user behaviors using chi-square tests, z tests, and t tests. The team conducted short phone calls with WhatsApp and SMS clients about their perceptions of this 2wT platform using a short, structured interview guide. We consider informal reflections from the technical team members on the use of WhatsApp. We applied an implementation science lens using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework to focus results on practice and policy improvement. Over a 2-month period-from August to October, 2023-337 males enrolled in 2wT and were offered WhatsApp or SMS and were included in the analysis. For 2wT reach, 177 (53%) participants chose WhatsApp as their platform (P=.38). Mean client age was 30 years, and 253 (75%) participants chose English for automated messages. From quality assurance calls, almost all respondents (87/89, 98%) were happy with the way they were followed up. For effectiveness, on average for the days on which responses were requested, 58 (33%) WhatsApp clients and 44 (28%) SMS clients responded (P=.50). All 2wT team members believed WhatsApp limited the automated message content, language choices, and inclusivity as compared with the SMS-based 2wT approach. When presented with a choice of 2wT communication platform, clients appear evenly split between SMS and WhatsApp. However, WhatsApp requires a smartphone and data plan, potentially reducing reach at scale. Clients using both platforms responded to 2wT interactive prompts, demonstrating similar effectiveness in engaging clients in follow-up. For telehealth interventions, digital health designers should maintain an SMS-based platform and carefully consider adding WhatsApp as an option for clients, using an implementation science approach to present evidence that guides the best implementation approach for their setting.

Exploring Client Preferences for Psychological Counselors in a Chinese Online Health Community: Longitudinal Study.

Although online health communities are acknowledged for their role in bridging the supply-demand gap in mental health services, the client decision-making process in these environments remains underexplored. This study aimed to explore the impact of different signals presented on psychological counselors' home pages on clients' choices. Adopting signaling theory as the framework, this study classified information into online and offline signals and developed a theoretical model to examine client choice behaviors. We collected data from 487 psychological counselors in a leading Chinese online mental health community during March, June, September, and December 2023. Based on these data, we constructed a 4-period balanced panel dataset. A fixed effects model was used to analyze which signals influence clients' choices of psychological counselors. Regarding online signals, the service price (β=0.186, P<.001) and online reputation (β=0.489, P=.002) of psychological counselors positively influence clients' choices. Concerning offline signals, psychological counselors' practical experience (β=0.007, P<.001) is positively related to clients' choices. Moreover, the results indicate that the relationship between a counselor's prosocial behavior and clients' choices is not linear but rather exhibits an inverted U-shape. This study reveals that the varied information provided by psychological counselors has distinct impacts on clients' choices in online health communities. It broadens the application of signaling theory to online behaviors and emphasizes the importance of both online and offline signals. These insights offer strategic guidance for counselors and online platforms to better meet potential clients' needs by optimizing the information presented on psychological counselors' home pages.

Beyond the hype: quantifying the impact of VR visualization on client preferences and price perception in AEC client pitching

The architectural, engineering, and construction (AEC) industries are using virtual reality (VR) to improve engagement and interactions. However, VR visualization’s effectiveness in client pitching is unclear. This study analyzes how VR visualization affects customer preferences and price, as well as the complex interaction between architectural scale and demographic aspects. The outcomes enable more precise and personalized VR implementation. VR is the favoured alternative, with 14% price premiums according to a statistical analysis. Its realistic field of view and immersion allow users to explore sites at their own leisure. VR represents all architectural typologies and sizes without compromise. This VR utilization can serve as an ameliorating tool to augment marketing and sales for the client pitching stage in the AEC sectors.

Clients prefer collaborative decision-making with veterinarians regardless of appointment type.

To determine clients' preferences for veterinarians' communication during decision-making in relation to 3 clinical contexts: preventive care, general problem (eg, illness or injury), and urgent appointments. A cross-sectional online questionnaire was distributed by use of snowball sampling to veterinary clients owning a pet. Demographic information was collected, and participants were then randomly assigned to a scenario reflecting one of the following clinical contexts (appointment types): preventive, general problem, or urgent. Discrete choice exercises were used to solicit client preferences for 5 aspects of veterinarians' communication approach to decision-making with clients in clinical contexts: amount of information, presentation of plan (options or a recommendation), communication of value, nature of client involvement, and communication of financial cost. Relative-preference scores were calculated using hierarchical bayesian modeling. Responses for 1,614 participants were included in the final analysis. The majority were female, lived in Canada, and were financially stable. Across clinical decision-making contexts, participants preferred to collaborate with the veterinarian, be offered options with a clear recommendation, be informed of present and future costs, and have benefits of any action regarding their pet's health explained to them. For the general-problem context, participants preferred veterinarians' communication to focus solely on concerns; in contrast, in preventive care and urgent contexts, participants preferred that communication include both normal findings and concerns. Irrespective of clinical decision-making context, participants preferred collaborative decision-making with a veterinarian. Veterinary professionals should consider, when possible, communication that supports a collaborative approach to decision-making with clients.

Discrepancies between treatment preference and effectiveness

AbstractInvolving clients in therapeutic decisions is a crucial component of effective and ethical behavior‐analytic practice. However, discrepancies between client preference for treatment options and treatment effectiveness are possible in the course of treatment. The purpose of this paper is to advance the discussion of discrepancies between client preference for treatment options and treatment effectiveness by (a) reviewing relevant considerations for adapted strategies to involve clients with limited prerequisite skills in therapeutic decisions, (b) presenting clinical data that exemplifies discrepancies between client preference for treatment options and treatment effectiveness, (c) describing nuanced considerations for navigating discrepancies, and (d) providing suggestions for future research on this topic.

Optimizing Nutritional Decisions: A Particle Swarm Optimization-Simulated Annealing-Enhanced Analytic Hierarchy Process Approach for Personalized Meal Planning.

Nutritionists play a crucial role in guiding individuals toward healthier lifestyles through personalized meal planning; however, this task involves navigating a complex web of factors, including health conditions, dietary restrictions, cultural preferences, and socioeconomic constraints. The Analytic Hierarchy Process (AHP) offers a valuable framework for structuring these multi-faceted decisions but inconsistencies can hinder its effectiveness in pairwise comparisons. This paper proposes a novel hybrid Particle Swarm Optimization-Simulated Annealing (PSO-SA) algorithm to refine inconsistent AHP weight matrices, ensuring a consistent and accurate representation of the nutritionist's expertise and client preferences. Our approach merges PSO's global search capabilities with SA's local search precision, striking an optimal balance between exploration and exploitation. We demonstrate the practical utility of our algorithm through real-world use cases involving personalized meal planning for individuals with specific dietary needs and preferences. Results showcase the algorithm's efficiency in achieving consistency and surpassing standard PSO accuracy. By integrating the PSO-SA algorithm into a mobile app, we empower nutritionists with an advanced decision-making tool for creating tailored meal plans that promote healthier dietary choices and improved client outcomes. This research represents a significant advancement in multi-criteria decision-making for nutrition, offering a robust solution to the inconsistency challenge in AHP and paving the way for more effective and personalized dietary interventions.

Preferences for Hypertension Care in Malawi: A Discrete Choice Experiment Among People Living with Hypertension, With and Without HIV.

Hypertension is the most common non-communicable disease diagnosed among people in sub-Saharan Africa. However, little is known about client preferences for hypertension care. We performed a discrete choice experiment in Malawi among people with hypertension, with and without HIV. Participants were asked to select between two care scenarios, each with six attributes: distance, waiting time, provider friendliness, individual or group care, antihypertensive medication supply, and antihypertensive medication dispensing frequency (three versus one month). Eight choice sets (each with two scenarios) were presented to each individual. Mixed effects logit models quantified preferences for each attribute. Estimated model coefficients were used to predict uptake of hypothetical models of care. Between July 2021 and April 2022 we enrolled 1003 adults from 14 facilities in Malawi; half were living with HIV and on ART for a median of 11years. Median age of respondents was 57years (IQR 49-63), 58.2% were female, and median duration on antihypertensive medications was 4years (IQR 2-7). Participants strongly preferred seeing a provider alone versus in a group (OR 11.3, 95% CI 10.4-12.3), with stronger preference for individual care among those with HIV (OR 15.4 versus 8.6, p < 0.001). Three-month versus monthly dispensing was also strongly preferred (OR 4.2; 95% CI 3.9-4.5). 72% of respondents would choose group care if all other facility attributes were favorable, although PLHIV were less likely to make this trade-off (66% versus 77%). These findings have implications for the scale-up of hypertension care in Malawi and similar settings.

Implementasi Extreme Programming untuk Sistem Jasa Pemesanan Design Website dan UI/UX

In this study, a website and UI/UX design ordering service system was developed. This system offers clients to make orders through a website that can make it easier for people to find service experts in the field of website and UI/UX design. The development of this system was carried out using the Extreme Programming (XP) method, this method is a software development that emphasizes flexibility, communication, and adaptability to changing requirements. Researchers will use short iterations to create, build, and test websites and UI/UX designs. To ensure a thorough understanding of client requests and preferences, developers and customers will communicate more frequently. The testing method on the system used in this study is User Acceptance Testing, which is a testing stage where the system or software is evaluated to ensure that the system meets user needs and requirements. Users perform this test to ensure that the system functions properly and meets their expectations. The results of this study, system development using the Extreme Programming (XP) method is very helpful for developers because the needs of each user are clearly defined, the use of the User Acceptance Testing method shows that each function of the application system operates according to user needs. Thus, the use of the Extreme Programming method can improve the system development.

Automating modular open-plan office layouts with performance-based generative design

Space planning, a crucial phase of architectural design, has significantly benefited from recent performance-based generative methods, enabling early discovery of innovative layouts among a wide range of alternatives. The application of generative design in open-office layout, where flexibility to support different work styles is essential, should become more practical. This paper fills gaps in automated space planning for office buildings, presenting a generative algorithm for robust circulation in multi-story modular geometries. By inputting a modular 3D model, the algorithm generates multiple interior configurations using a library of predefined modules adaptable to cube dimensions and client preferences. This facilitates extensive layout options, streamlining decision-making for efficient workstation and corridor designs. The use of a user-friendly visualization platform allows standard drawing modifications by architects with no programming knowledge. The algorithm's effectiveness is proven through application on various 3D geometries, showcasing its potential to improve practical office design.

Factors influencing Customer Purchasing Attitudes towards F-commerce in Bangladesh: Youth Group Perspective

The study's objective is to identify the key factors that influence customers' attitudes towards purchasing on Facebook and establish the relationship between these variables and consumers' buying behavior on f-commerce. A quantitative research design was utilized to accomplish the goal of the study. This study utilized convenience sampling as a non-probability method of sampling. The study was conducted with a sample size of 219 young individuals engaged in online purchasing. In addition, the data was analyzed using the Structural Equation Model (SEM) with the assistance of PLS 4.0. Finally, the results demonstrate the intricate interaction between multiple factors and client preferences. Trust-related concerns, such as protecting sensitive information and online safety, significantly shape buying decisions of young customer groups. This study suggests that sales services, including prompt delivery and promotional activities, affect customers' opinions of f-commerce. F-commerce is also influenced by promotional activities, which in turn shape young consumers' perceptions. The report highlights the importance of companies understanding and addressing these factors in order to enhance customer engagement and achieve success in the digital marketplace. The study's findings will assist f-commerce enterprises in developing customized marketing plans for young customers.

Client perspectives: Telehealth for mental health services.

The COVID-19 pandemic required mental health clinicians globally to transition to the delivery of care via telehealth. This study aimed to gain an understanding of clients' satisfaction with and attitudes towards telehealth mental health services. Seventy adults who had attended a clinic for mood and anxiety disorders, and participated in at least one telehealth consultation with a psychologist or psychiatrist, completed an anonymous online survey. The majority of participants (81.5%) reported satisfaction with telehealth mental health care provided during the COVID-19 pandemic. However, satisfaction overall was significantly higher amongst participants who had received both telehealth and face-to-face mental health care, compared to participants who received care via telehealth only. Advantages of telehealth care reported included convenience and increased access to mental health clinicians. However, disadvantages of telehealth care included greater difficulty developing a rapport with a clinician and expressing oneself via telehealth. Whilst client satisfaction with telehealth mental health care for mood and anxiety disorders is generally high, clinicians should consider the limitations of telehealth from clients' perspectives. In particular, strategies to enhance therapeutic connection during telehealth sessions may be needed, and client preferences for mode of delivery should be taken into consideration when possible.

Elucidating the process-based emphasis in cognitive behavioral therapy

This paper delves into the examination of cognitive behavioral therapy (CBT), a therapeutic modality reliant on both longitudinal and cross-sectional biopsychosocial data regarding the client, through the lens of evolutionary language within a process-based therapy (PBT) framework. The exposition commences with an elucidation and delineation of pivotal features and assumptions underpinning CBT, encompassing its philosophical foundations, postulated change processes, and the empirical research substantiating these processes. We posit ideas for clinicians to enhance their case formulation by incorporating process-based principles into CBT, invoking concepts such as variation, selection, retention, and contextual fit. Furthermore, we offer a case illustration and a treatment plan utilizing a network-based approach. In conclusion, we explore potential strengths, barriers, and future trajectories for PBT. Although CBT has predominantly undergone scrutiny as a treatment protocol in group-level outcome studies, we assert that CBT inherently operates as a process-driven model, as evidenced by established metrics assessing therapist competence in its implementation. Specifically, we illustrate how the judicious selection and utilization of specific procedures (techniques) targeting change processes emanate from an individualized and integrative case formulation. This formulation is rooted in the evidence supporting the chosen procedure, aligned with the client's preferences and goals, and embedded within the in-session process of selecting, planning, and reviewing between-session homework. CBT, therefore, emerges as a model for clinical practice and training characterized by inherent pragmatism, integrativeness, and transtheoreticism. It aligns seamlessly with the emphasis on process-informed, person-centered, evidence-based treatment within the PBT framework.

The use of practice evidence by Australian occupational therapists: Perspectives and actions.

Evidence-based practice supports clinical decision-making by using multiple sources of evidence arising from research and practice. Research evidence develops through empirical study while practice evidence arises through clinical experience, client preferences, and the practice context. Although occupational therapists have embraced the paradigm of evidence-based practice, some studies have identified limits in the availability and use of research, which can lead to reliance on other forms of evidence. This study aimed to understand how Australian occupational therapists use practice evidence, manage potential bias, and enhance trustworthiness. Potential use of a critical appraisal tool for practice evidence was also explored. A 42-item questionnaire was developed to address the study aims. It consisted of a 7-point Likert scale, ordinal and free text questions. Likert scales were collapsed into binary scales and analysed using SPSS. Ordinal data were graphed and free text responses were analysed using manifest content analysis. Most respondents (82%) indicated that practice evidence was an important informant of practice and is used alongside research evidence. Almost all respondents (98%) expressed confusion when reconciling discrepancies between research and practice evidence. There was general acknowledgement that practice evidence is prone to bias (82%), yet 92% were confident in trusting their own practice evidence. Most respondents (74.5%) undertook some measures to appraise practice evidence, and almost all respondents (90%) agreed they would refer to a critical appraisal tool that helped them evaluate practice evidence. Occupational therapists in this study routinely use practice evidence arising from their own experience, client perspectives, and their practice context to inform clinical decision-making. While they agreed that practice evidence was prone to bias and misinterpretation, they generally trusted their own practice evidence. Participants indicated they needed guidance to critically appraise their practice evidence and supported the development of a critical appraisal tool for this purpose.

Client preferences for the design and delivery of injectable opioid agonist treatment services: Results from a best-worst scaling task.

Clinical trials support injectable opioid agonist treatment (iOAT) for individuals with opioid use disorder (OUD) for whom other pharmacological management approaches are not well-suited. However, despite substantial research indicating that person-centered care improves engagement, retention and health outcomes for individuals with OUD, structural requirements (e.g. drug policies) often dictate how iOAT must be delivered, regardless of client preferences. This study aimed to quantify clients' iOAT delivery preferences to improve client engagement and retention. Cross-sectional preference elicitation survey. Metro Vancouver, British Columbia, Canada. 124 current and former iOAT clients. Participants completed a demographic questionnaire package and an interviewer-led preference elicitation survey (case 2 best-worst scaling task). Latent class analysis was used to identify distinct preference groups and explore demographic differences between preference groups. Most participants (n = 100; 81%) were current iOAT clients. Latent class analysis identified two distinct groups of client preferences: (1) autonomous decision-makers (n = 73; 59%) and (2) shared decision-makers (n = 51; 41%). These groups had different preferences for how medication type and dosage were selected. Both groups prioritized access to take-home medication (i.e. carries), the ability to set their own schedule, receiving iOAT in a space they like and having other services available at iOAT clinics. Compared with shared decision-makers, fewer autonomous decision-makers identified as a cis-male/man and reported flexible preferences. Injectable opioid agonist treatment (iOAT) clients surveyed in Vancouver, Canada, appear to prefer greater autonomy than they currently have in choosing OAT medication type, dosage and treatment schedule.

Analyzing the Reasons on Decreasing in Sales for Tesla

Since the end of the epidemic, people's travel demand has gradually recovered, and the demand for transportation has greatly increased; however, in this context, Tesla Motors has experienced a decline in sales. The aim of this study was to examine the reasons that contributed to the decrease in Tesla's sales in the first quarter of 2024. This article examines the variables that have contributed to the decline in Tesla's sales by reviewing sales statistics from previous years in Europe, the United States, and China. This study subsequently outlines the three main variables that are responsible for the decrease in sales for Tesla. The reasons include several variables, such as production challenges, increased competition, and a negative shift in client preferences. This article proposes three ideas to tackle the problem of decreasing sales: diversifying the product range, establishing strategic alliances, and enhancing the charging infrastructure. Moreover, this post has greatly advanced the electric vehicle market by clarifying the reasons for its decline and providing helpful suggestions.

The effects of a client's social media disclosure and audience engagement on auditor judgment

The rapid rise of social media enables companies to disclose information to the public instantly. Thus, auditors may initially receive client information via a client's social media account instead of through private, client-to-auditor communication. Drawing on Social Penetration Theory, we conduct an experiment to investigate how a client's initial disclosure via social media (versus private disclosure) and audience engagement of the client's posts (e.g., number of “likes,” “replies,” and “reposts”) affects auditors' perception of the auditor-client relationship and their evaluation of the client-provided information. We find that when auditors initially receive client information via social media with high audience engagement, they are less willing to accept the client's preference than when the same information is disclosed privately or publicly with minimal audience engagement. Our findings are consistent with auditors perceiving client disclosure via social media with high audience engagement as a significant violation of their communication expectations such that their relational closeness with the client weakens and causes them to respond critically. We contribute to the literature on the use of social media for corporate disclosure, which has implications for the auditor-client relationship and audit quality.

Staff and client preferences for the design and delivery of an outcomes monitoring system in a mental health service.

Outcome monitoring can support the delivery of quality service that meets the needs of clients, clinicians and services. However, few studies have examined client or staff perspectives on the design and implementation of outcomes monitoring within a service. Implementation of outcomes monitoring requires understanding the preferences and expectations of relevant stakeholders. Informed by the Consolidated Framework for Implementation Research, this study aimed to investigate the preferences and priorities of relevant staff, clients and family members to inform the design and implementation of an effective outcomes monitoring system in the context of a mental health service for military veterans and their families. Twenty-nine staff participated across five online focus groups, including clinical staff, peer workers, policy staff and supervisors. Ten clients participated in online or telephone semi-structured interviews. Thematic analysis was used to develop themes from the data. Clients and staff agreed that outcomes monitoring should cover more than symptoms, particularly by incorporating functional outcomes. Assessing mental health over time was considered a valuable tool for supporting treatment processes and providing actionable information. Challenges identified by clients and staff included the need for efficient processes, ensuring measures are relevant and acceptable, and maintaining client privacy. The ability to personalise data collection and have a streamlined, responsive system were key attributes of a quality outcomes monitoring framework. Findings suggest that an effective outcome monitoring framework should be client-led, tailored to the individual's needs, and provide feedback on progress. Outcomes monitoring should also be efficient, accessible and allow for safe information sharing.

No Man Is an Island: Resiliency Among Older African American Men Living with HIV

ABSTRACT African American men face chronic illness earlier in life and earlier death due to higher severity of illness and poor control of chronic diseases than their white male counterparts. Preexposure and post-exposure prophylaxis PrEP and PREP have improved the odds of survival among those living with HIV. However, the anti-retroviral treatments, though effective, are only as effective as early prevention and detection and in cases where patients can adhere to treatment regimens. The mean age of participants (N = 11) was 56.44 (SD = 5.175, range = 47–63). The current study employs qualitative methodology to propose an ecosystems-driven intersectional model to identify resilience and the influence of personal, social, and societal forces shaping the lives of older African American men living with HIV. Findings determine stigma, community violence, and structural barriers to care as crucial stress areas. Participants discussed self-advocacy and family as constituent elements of resilience. Several implications for practice and research emerged. Practice must design and deploy assessment instruments to include exposure to racism and violence, including emotional and structural violence. Practice must include advocacy at the micro, meso, and macro levels. Assessment must also be self-reflexive. Organizational assessment should involve internal and structural reviews of barriers to meeting client preferences.