An interventional study of Choose to Move Replacement Ready in Osteoarthritis (OA), Osteoarthritis (OA) of the Hip and Osteoarthritis (OA) of the Knee, sponsored by University of British Columbia. Recruiting at 1 site in Canada. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2026-08-24.
Sponsored by University of British Columbia · Not applicable, Interventional, and Supportive care
Choose to Move (CTM) is a 3-month, choice-based health-promoting program for low active older adults being scaled-up across British Columbia (BC), Canada. Recently, the investigators adapted CTM for the >14000 people in BC who are on surgical waitlists for total knee replacement or total hip replacement (TKR/THR) for osteoarthritis (OA). The primary goals of this observational study are to describe how the adapted program, Choose to Move Replacement Ready (CTM-RR), is implemented in BC and determine if the adapted program improves health outcomes in people with hip and/or knee osteoarthritis who are on surgical waitlists for TKR/THR. The investigators will also evaluate whether any health benefits achieved by CTM-RR participants are maintained three months after they finish the program and also during the remaining time that they wait for their TKR/THR surgery.
The investigators will work with referral partners from hospitals and orthopaedic clinics in BC to recruit participants into CTM-RR. Participants who enrol in CTM-RR will answer online survey questions about the program and about their physical activity, mobility, pain, function, quality of life, willingness to undergo surgery, overall perception of their joint condition, psychosocial health, self-efficacy, social isolation, loneliness, and sedentary time. CTM-RR activity coaches will also answer online survey questions about the program. CTM-RR participants, activity coaches, and referral partners will also participate in interviews about the program.
Choose to Move (CTM) an effective 3-month, choice-based health-promoting program for low active older adults being scaled-up in phases across British Columbia (BC), Canada. Choose to Move Replacement Ready (CTM-RR) is an adapted version of the program tailored to support individuals with hip and/ or knee osteoarthritis on surgical waitlists for TKR/THR, with the overall goal of enhancing key health outcomes. Referral partners from hospitals and orthopaedic clinics in BC will inform patients about CTM-RR when they are booked for a hip or knee replacement surgery. Trained activity coaches hired by the Active Aging Society will deliver the online CTM-RR program to individuals on surgical waitlists for TKR/THR who register for the program. The investigators will then evaluate implementation of CTM-RR, impact of CTM-RR on participants' physical and social health, and maintenance of any health benefits.
The primary aim of this trial is to assess implementation and effectiveness of the adapted CTM-RR program. The specific objectives are to:
In partnership with the Active Aging Society, the investigators aim to deliver 20 CTM-RR online programs over two years to approximately 300 participants across BC. There is no cost to participate in the CTM-RR program, and individuals may participate in CTM-RR regardless of whether they choose to be evaluated as part of this trial. The investigators expect approximately 70% of CTM-RR participants to volunteer for the evaluation.
The investigators will conduct a pre-post, observational cohort trial using a hybrid implementation effectiveness type 2 trial design. Data will be collected at 0 (baseline), 3 (postintervention), and 6 (long-term follow-up) months and 2-weeks before surgery (pre-operative) to assess implementation and impact of CTM-RR, and maintenance of any program-related benefits.
2,974 studies on the registry are indexed under Osteoarthritis; 438 are open to participants now.
This study's planned enrollment of 210 is above the median of 80 across 2,240 interventional studies indexed under Osteoarthritis.
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Exclusion Criteria:
Choose to Move Replacement Ready CTM-RR is a 3-month program for individuals with hip and/or knee osteoarthritis on surgical waitlists for total hip or total knee replacement that includes three required components: 1) a 30-min one-on-one virtual consultation (via Zoom) where activity coaches support participants to set goals and develop a physical activity (PA) action plan; 2) 8 virtual group meetings (via Zoom, 90-min each) facilitated by activity coaches, with participants (10/program) who provide peer support. Each meeting includes: i) two, 15-min movement breaks where participants perform structured hip and knee exercises delivered by the coach and ii) education and discussion on relevant topics (e.g. goal setting, PA, what to expect from surgery); 3) Home-based hip and knee exercises to complete independently, 2x/week. Optional components of CTM-RR include 4) a bi-weekly newsletter distributed by the Active Aging Society and 5) peer support check-ins outside of group meetings.
Behavioral: Choose to Move Replacement Ready
As described under study arm description.
Implementation outcome: Fidelity (Proportion of participants who adhered to CTM-RR program components)
Obtained from post-program survey. Measures adherence to prescribed frequency, intensity, duration, and type of exercises performed, and attendance at CTM-RR group meetings.
Time frame: 3 months
Effectiveness outcome: Change in physical activity
Single-item physical activity questionnaire. Output measure is self-reported number of days engaging in ≥30 minutes of moderate-to-vigorous physical activity in the past week (range 0-7). Higher scores reflect a better outcome (i.e. increased physical activity)
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Reach
Number of individuals participating in CTM-RR programs will be obtained from program records
Time frame: 3 months
Retention
Obtained from evaluation records. Proportion of participants who consent to the evaluation who complete each assessment.
Time frame: Baseline, 3 and 6 months, 2 weeks pre-operative
Dose delivered
Obtained from post-program survey. Proportion of required intervention components (group meetings and one-on-one consultations) delivered by activity coaches.
Time frame: 3 months
Adoption
Obtained from program records. Number of referral partners who refer participants to the program.
Time frame: 3 months
Adaptation (survey)
Planned or purposeful changes to the delivery of CTM-RR by activity coaches will be assessed by survey (short answer responses; developed in house). Coaches will indicate if they made any adaptations to the program (yes/no) and to provide details of any adaptations such as why it needed to occur.
Time frame: 3 months
Satisfaction with CTM-RR (survey)
Satisfaction with CTM-RR will be assessed via participant (older adults) survey (designed in house). Higher scores (1-5 Likert scale) indicate higher participant satisfaction with the intervention.
Time frame: 3 months
Change in walking time
International Physical Activity Questionnaire (IPAQ-SF): assesses self-reported weekly minutes of walking
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in sedentary time
International Physical Activity Questionnaire (IPAQ-SF): assesses self-reported weekly minutes of sedentary time
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in bone and muscle strengthening activity
Single-item muscle strengthening activity survey. Number of days in past week doing activities that increase bone and muscle strength
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in balance activity
Single-item activity survey. Number of days in past week doing activities that improve balance.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in capacity for mobility
Short-Form-36 health survey (SF-36) Physical Functioning Scale: two items assess self-reported ability to walk ¼ mile and 1 flight of stairs.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in social isolation
Social Isolation Questionnaire: score (0-15) reflects the degree of social interaction and support. Higher scores indicate a greater level of social interaction and support.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in loneliness
The 3-item U.S. Health and Retirement Study Participant Lifestyle Questionnaire reflects experiences of loneliness. Each item is scored on a scale of 1-3. The output variable is the summed score of the 3 items (range 3-9); Higher scores indicate greater perceived loneliness.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in ability to participate in daily activities
The four-item PROMIS- Ability to Participate in Social Roles and Activities Scale- short form 4a will be used to assess perceived ability to perform one's usual social roles and activities. Each item is scored on a scale of 1-5. The output variable is the summed raw score of all 4-items (range 4-20) converted into a T-score (27.5-64.2) ; higher scores indicate greater ability to engage in social roles and activities.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in Hip disability and Osteoarthritis Outcome 12-item Score
The 12-item Hip Disability and Osteoarthritis Outcome Score (HOOS-12) assesses patients' hip condition (pain, function, quality of life). Each item is scored on a scale of 0-10. The output variable is the average score of the 12-items (range 0-100); higher scores indicate worse hip problems.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in Knee disability and Osteoarthritis Outcome 12-item Score
The 12-item Knee Disability and Osteoarthritis Outcome Score (KOOS-12) assesses patients' knee condition (pain, function, quality of life). Each item is scored on a scale of 0-10. The output variable is the average score of the 12- items (range 0-100); higher scores indicate worse knee problems.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in patient global assessment of target joint
Single-item measure using a numerical rating scale: score (0-10) assesses the overall condition of the affected hip or knee joint. Higher scores indicate worse condition (severe symptoms).
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in arthritis-specific self-efficacy
The 8-item questionnaire assesses how certain an individual is that they can manage various aspects of their arthritis. Each item is scored on a scale of 1-10. The output variable is the average score of all 8-items (range 8-80); higher scores indicate more self-efficacy.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in pain intensity
Pain Numerical Rating Scale (NRS): score (0-10) assesses pain intensity on average during the past week. Higher scores indicate worse pain intensity.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in willingness to undergo surgery
One item will assess participants' willingness to undergo hip or knee replacement surgery. The question asks: "What is your current willingness to undergo a \[total hip replacement surgery or total knee replacement surgery\]?" The response options are: definitely unwilling, probably unwilling, unsure, probably willing or definitely willing. Definitely unwilling, probably unwilling, unsure= No, and probably willing or definitely willing=Yes. The output variable is self-reported willingness to undergo surgery (yes/no).
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in anxiety
The Generalized Anxiety Disorder 7-item scale (GAD-7) will be used to assess the presence of anxiety. Each item is scored on a scale of 0-3. The output variable is the summed total of all scores (range 0-21); higher scores indicate greater levels of anxiety.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in kinesiophobia
The 11-item Tampa Scale for Kinesiophobia (TSK-11) assesses fear of movement in individuals with chronic pain. Each item is scored on a scale of 1-4. The output variable is the total summed score of all 11-items (range 11-44); higher scores indicate greater fear of movement.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Change in exercise self-efficacy
The 10-item Exercise Self-Efficacy Scale (ESES) assesses how confident participants are with regard to carrying out regular physical activities and exercise. Each item is scored on a scale of 1-4. The output variable is the total summed score of all 10 items (range 10-40); higher scores indicate greater self-efficacy for exercise.
Time frame: baseline, 3 and 6 months, 2 weeks pre-operative
Perceived participant responsiveness (survey)
Perceived participant responsiveness will be assessed via participant (older adults) survey ( short answer responses; developed in house). Older adults will indicate which optional intervention components they engaged in (peer check-in, e-mail newsletter, hip and knee exercises; yes/no response options)
Time frame: 3 months
Acceptability - CTM-RR program
Acceptability of Intervention Measure (AIM). Activity coaches' perception that CTM-RR is agreeable or satisfactory will be assessed by survey (4 items each on a 1-5 Likert scale with 1 being completely disagree and 5 being completely agree).
Time frame: 3 months
Appropriateness - CTM-RR program
Intervention Appropriateness Measure (IAM). Extent to which CTM-RR fits the needs of the target population will be assessed by survey (4 items each on a 1-5 Likert scale with 1 being completely disagree and 5 being completely agree)
Time frame: 3 months
Feasibility - CTM-RR program
Feasibility of Intervention Measure (FIM). Activity coaches' perception that CTM-RR is feasible to deliver will be assessed by survey (4 items each on a 1-5 Likert scale with 1 being completely disagree and 5 being completely agree).
Time frame: 3 months
Adaptation (interview)
Planned or purposeful changes to the delivery of CTM-RR by activity coaches will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 months
Experience with training and program delivery (interview)
Activity coaches overall experience with program training and delivery, will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 months
Perceived participant responsiveness (interview)
Activity coaches' perceptions of participant responsiveness will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 months
Adaptations (interview)
Older adults' perceptions of potential adaptations to improve the program will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 and 6 months
Perceived participant responsiveness (interview)
Older adults' responsiveness during the program will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 and 6 months
Acceptability- CTM-RR program (interview)
Older adults' perceptions that the program is acceptable or satisfactory will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 and 6 months
Feasibility- CTM-RR program (interview)
Older adults' perceptions of the program's feasibility will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 and 6 months
Appropriateness- CTM-RR program (interview)
Older adults' perceptions of the program's appropriateness will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 and 6 months
Feasibility - CTM-RR referral process (interview)
Referral partners' perception that the CTM-RR referral process can be used successfully within the organization will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 months
Acceptability - CTM-RR referral process (interview)
Referral partners' perception that the CTM-RR referral process is acceptable or satisfactory will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 months
Appropriateness - CTM-RR referral process (interview)
Referral partners' perception regarding the extent to which the CTM-RR referral process fits with the mission, priorities, and values of the organization will be assessed by interview (no score associated with qualitative interview).
Time frame: 3 months
Sociodemographics
22-item survey (developed in house) to capture sociodemographic characteristics of older adults including: postal code, city, age, gender, sex, height, weight, ethnicity, education level, employment status, chronic diseases, disability, living arrangement, marital status, affected joint (surgical hip or knee), other affected joints (hip/knee/spine/hands/feet), date of surgery (if known), time on waitlist, name of operating surgeon/hospital, years with hip/knee symptoms most days of the week, prior total hip/knee replacement, medication use, use of muscle strengthening exercises for their joint pain or general aerobic fitness exercise for their joint pain in the last three months, and referral source.
Time frame: Baseline
Surgery date
Determined from monthly survey sent to older adults if surgery date is not known when they complete the CTM-RR program.
Time frame: Monthly following program completion until surgery date is known (assessed up to two years).
Plan to share: Undecided
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