Abstract
BACKGROUND: Older adults living with HIV/AIDS face greater risks and challenges in disease management. In China, there is currently a lack of empowerment-based management programs tailored to this population. The ADAPT-ITT framework offers a culturally adaptable approach to designing individualized interventions that improve acceptability and sustainability. METHODS: A preliminary program was developed on the basis of comprehensive semistructured interviews, a literature review, and group discussions. A two-round Delphi survey involving 19 experts was conducted to refine and finalize the program. This study strictly adheres to the Delphi Research Implementation and Reporting Guidelines (CREDES) and the Qualitative Research Reporting Standards (COREQ) to ensure methodological rigor and transparency. Consensus was determined via a 5-point Likert scale, analyzing medians, interquartile ranges (IQRs), and percentage scoring. RESULTS: Two rounds of expert consultation were completed. The response rates were 82.61% and 89.47%, respectively. The authority coefficients were 0.900 and 0.902. Kendall’s W coefficients were 0.113 (χ²=149.436, P < 0.001) and 0.177 (χ²=231.201, P < 0.001). On the basis of expert feedback, the final program consisted of 10 primary indicators, 25 secondary indicators, and 42 tertiary indicators. CONCLUSIONS: The empowerment-based management program developed via the ADAPT-ITT framework demonstrated good scientific validity and expert consensus. This program can provide a practical basis for delivering individualized, targeted interventions for older adults with HIV/AIDS, thereby improving their self-management capabilities and treatment adherence. CLINICAL TRIAL NUMBER: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13880-6.