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NCT Number: NCT07696650

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

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.

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Key information

About this study

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:

  • assess implementation of CTM-RR. Specifically, implementation determinants (context, acceptability, feasibility, appropriateness, self-efficacy) and implementation outcomes (1° implementation outcome: fidelity; 2° implementation outcomes: reach, retention, adoption, dose, adaptation, satisfaction).
  • evaluate effectiveness of CTM-RR. Specifically, whether CTM-RR increases participants' pre-operative moderate-to-vigorous physical activity (moderate to vigorous physical activity, 1° effectiveness outcome), mobility, psychosocial health, self-efficacy to manage their condition; improves their pain, function, quality of life, and perception of their joint condition, and decreases social isolation and loneliness (2° effectiveness outcomes).
  • evaluate if participant health benefits (if any) are maintained 3 months after CTM-RR is completed.
  • evaluate if participant health benefits (if any) are maintained up until participant's surgery (i.e. during the remaining surgical waiting period).

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

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

Exclusion criteria

  • non-English speaking activity coach
  • non-English speaking referral partner

Treatment and study plan

Choose to Move Replacement Ready

Behavioral

As described under study arm description.

Primary outcomes

  1. Implementation outcome: Fidelity (Proportion of participants who adhered to CTM-RR program components)

    Time frame: 3 months

    Obtained from post-program survey. Measures adherence to prescribed frequency, intensity, duration, and type of exercises performed, and attendance at CTM-RR group meetings.

  2. Effectiveness outcome: Change in physical activity

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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)

Secondary outcomes

  1. Reach

    Time frame: 3 months

    Number of individuals participating in CTM-RR programs will be obtained from program records

  2. Retention

    Time frame: Baseline, 3 and 6 months, 2 weeks pre-operative

    Obtained from evaluation records. Proportion of participants who consent to the evaluation who complete each assessment.

  3. Dose delivered

    Time frame: 3 months

    Obtained from post-program survey. Proportion of required intervention components (group meetings and one-on-one consultations) delivered by activity coaches.

  4. Adoption

    Time frame: 3 months

    Obtained from program records. Number of referral partners who refer participants to the program.

  5. Adaptation (survey)

    Time frame: 3 months

    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.

  6. Satisfaction with CTM-RR (survey)

    Time frame: 3 months

    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.

  7. Change in walking time

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    International Physical Activity Questionnaire (IPAQ-SF): assesses self-reported weekly minutes of walking

  8. Change in sedentary time

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    International Physical Activity Questionnaire (IPAQ-SF): assesses self-reported weekly minutes of sedentary time

  9. Change in bone and muscle strengthening activity

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    Single-item muscle strengthening activity survey. Number of days in past week doing activities that increase bone and muscle strength

  10. Change in balance activity

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    Single-item activity survey. Number of days in past week doing activities that improve balance.

  11. Change in capacity for mobility

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

  12. Change in social isolation

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

  13. Change in loneliness

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

  14. Change in ability to participate in daily activities

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

  15. Change in Hip disability and Osteoarthritis Outcome 12-item Score

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

  16. Change in Knee disability and Osteoarthritis Outcome 12-item Score

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

  17. Change in patient global assessment of target joint

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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).

  18. Change in arthritis-specific self-efficacy

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

  19. Change in pain intensity

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    Pain Numerical Rating Scale (NRS): score (0-10) assesses pain intensity on average during the past week. Higher scores indicate worse pain intensity.

  20. Change in willingness to undergo surgery

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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).

  21. Change in anxiety

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

  22. Change in kinesiophobia

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

  23. Change in exercise self-efficacy

    Time frame: baseline, 3 and 6 months, 2 weeks pre-operative

    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.

Other outcomes

  1. Perceived participant responsiveness (survey)

    Time frame: 3 months

    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)

  2. Acceptability - CTM-RR program

    Time frame: 3 months

    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).

  3. Appropriateness - CTM-RR program

    Time frame: 3 months

    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)

  4. Feasibility - CTM-RR program

    Time frame: 3 months

    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).

  5. Adaptation (interview)

    Time frame: 3 months

    Planned or purposeful changes to the delivery of CTM-RR by activity coaches will be assessed by interview (no score associated with qualitative interview).

  6. Experience with training and program delivery (interview)

    Time frame: 3 months

    Activity coaches overall experience with program training and delivery, will be assessed by interview (no score associated with qualitative interview).

  7. Perceived participant responsiveness (interview)

    Time frame: 3 months

    Activity coaches' perceptions of participant responsiveness will be assessed by interview (no score associated with qualitative interview).

  8. Adaptations (interview)

    Time frame: 3 and 6 months

    Older adults' perceptions of potential adaptations to improve the program will be assessed by interview (no score associated with qualitative interview).

  9. Perceived participant responsiveness (interview)

    Time frame: 3 and 6 months

    Older adults' responsiveness during the program will be assessed by interview (no score associated with qualitative interview).

  10. Acceptability- CTM-RR program (interview)

    Time frame: 3 and 6 months

    Older adults' perceptions that the program is acceptable or satisfactory will be assessed by interview (no score associated with qualitative interview).

  11. Feasibility- CTM-RR program (interview)

    Time frame: 3 and 6 months

    Older adults' perceptions of the program's feasibility will be assessed by interview (no score associated with qualitative interview).

  12. Appropriateness- CTM-RR program (interview)

    Time frame: 3 and 6 months

    Older adults' perceptions of the program's appropriateness will be assessed by interview (no score associated with qualitative interview).

  13. Feasibility - CTM-RR referral process (interview)

    Time frame: 3 months

    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).

  14. Acceptability - CTM-RR referral process (interview)

    Time frame: 3 months

    Referral partners' perception that the CTM-RR referral process is acceptable or satisfactory will be assessed by interview (no score associated with qualitative interview).

  15. Appropriateness - CTM-RR referral process (interview)

    Time frame: 3 months

    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).

  16. Sociodemographics

    Time frame: Baseline

    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.

  17. Surgery date

    Time frame: Monthly following program completion until surgery date is known (assessed up to two years).

    Determined from monthly survey sent to older adults if surgery date is not known when they complete the CTM-RR program.

Study contacts

Contact information is provided by the study sponsor or research team.

Douglas L Race, MSc

CONTACT

[email protected]

604-875-4111 ext. 21787

Giulia Coletta, PhD

CONTACT

[email protected]

604-875-4111

Sponsors and collaborators

Lead sponsor

University of British Columbia

Other

Collaborators

  • Active Aging Society
  • Specialist Services Committee (Doctors of BC)

Registry information

Official study title

Choose to Move Replacement Ready: Implementation and Effectiveness of a Virtual Health-Promoting Intervention for People Awaiting Total Hip or Knee Replacement Surgery

Acronym: CTM-RR

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Jul 10, 2026
Registry last updated
Jul 10, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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