Feasibility of Choose to Move Replacement Ready (CTM-RR)

University of British Columbia

Status: Enrolling

Conditions: Implementation Science; Physical Inactivity; Osteoarthritis, Hip; Osteoarthritis; Sedentary Behaviors; Total Knee Arthroplasty; Total Hip Arthroplasty; Mobility Limitation; Osteoarthritis (OA) of the Knee; Pain; Social Isolation or Loneliness

Treatments: Behavioral: Choose to Move Replacement Ready

Study type: Interventional

Funder types: Other

Identifiers

NCT07069179

H24-03805

Details and patient eligibility

About

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 goal of this observational study is to learn if the adapted program, Choose to Move Replacement Ready (CTM-RR), is feasible to deliver to people with hip and/or knee osteoarthritis who are on surgical waitlists for TKR/THR.

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.

Full description

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. Trained activity coaches hired by the Active Aging Society will deliver CTM-RR to individuals on surgical waitlists for TKR/THR. The investigators will then evaluate implementation of CTM-RR, and the impact of CTM-RR on participants' physical and social health.

The primary objective of this trial is to:

1. Assess implementation outcomes (participant recruitment, retention, dose delivered/received, fidelity) of the adapted CTM model against predetermined feasibility targets.

   The secondary objectives are to:

2. Describe implementation determinants (acceptability, feasibility, appropriateness) and outcomes (reach, adaptations, perceived participant responsiveness, adoption) of the adapted CTM model.

3. Evaluate the preliminary estimates of effectiveness of CTM-RR. Specifically, whether CTM-RR increases participants' pre-operative moderate-to-vigorous physical activity, light physical activity, mobility, psychosocial health, and self-efficacy to manage their condition; improves their perception of their joint condition, function, and quality of life; and decreases pain, social isolation, loneliness, and sedentary time

4. Assess whether participant-level health benefits, if any, are maintained 6 months after participants complete the CTM-RR program.

In partnership with the Active Aging Society, the investigators aim to deliver 6 CTM-RR online programs over 9-months to approximately 60 participants total 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 will conduct a feasibility trial using a hybrid implementation-effectiveness type 2 trial design. Data will be collected at 0 (baseline), 3 (post-intervention), and 9 (long-term follow-up) months to assess implementation and impact of CTM-RR, and maintenance of any program-related benefits. The investigators will also collect physical activity logs from program participants (weekly, during program participation).

Enrollment: 60 estimated patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Activity coach hired by the Active Aging Society (activity coaches must speak English to participate in the evaluation);
2. English-speaking older adults (aged >=50 years) who participate in CTM-RR will be invited to participate in the evaluation
3. Referral partner (People who work in a healthcare setting who refer patients into the program)

Exclusion criteria

1. non-English speaking activity coach
2. non-English speaking referral partner

Trial design

Primary purpose: Supportive Care

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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60 participants in 1 patient group

Choose to Move Replacement Ready

Experimental group

Description:

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 PA action plan; 2) 8 virtual group meetings (via Zoom, 90-min each) facilitated by activity coaches, with small groups of 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 AAS and 5) peer support check-ins outside of group meetings.

Treatment:

Behavioral: Choose to Move Replacement Ready