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

July 8, 2026 updated by: Heather McKay, University of British Columbia

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

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.

Study Overview

Detailed 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. 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:

  1. 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).
  2. 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).
  3. evaluate if participant health benefits (if any) are maintained 3 months after CTM-RR is completed.
  4. 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.

Study Type

Interventional

Enrollment (Estimated)

210

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • British Columbia
      • Vancouver, British Columbia, Canada, V5Z 1M9
        • Active Aging Research Team, Robert H. N. Ho Research Centre
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Choose to Move Replacement Ready
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.
As described under study arm description.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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.
3 months
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)

baseline, 3 and 6 months, 2 weeks pre-operative

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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.
3 months
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.
3 months
Reach
Time Frame: 3 months
Number of individuals participating in CTM-RR programs will be obtained from program records
3 months
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.
Baseline, 3 and 6 months, 2 weeks pre-operative
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.
3 months
Adoption
Time Frame: 3 months
Obtained from program records. Number of referral partners who refer participants to the program.
3 months
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
baseline, 3 and 6 months, 2 weeks pre-operative
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
baseline, 3 and 6 months, 2 weeks pre-operative
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
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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).
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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).
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative
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.
baseline, 3 and 6 months, 2 weeks pre-operative

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
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 months
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)
3 months
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).
3 months
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)
3 months
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).
3 months
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).
3 months
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).
3 months
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).
3 and 6 months
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).
3 and 6 months
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).
3 and 6 months
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).
3 and 6 months
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).
3 and 6 months
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).
3 months
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).
3 months
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).
3 months
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.
Baseline
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.
Monthly following program completion until surgery date is known (assessed up to two years).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Heather A McKay, PhD, University of British Columbia
  • Principal Investigator: Joanie Sims Gould, MSW, PhD, University of British Columbia
  • Principal Investigator: Laura Churchill, PT, PhD, University of British Columbia

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 1, 2026

Primary Completion (Estimated)

August 1, 2028

Study Completion (Estimated)

August 1, 2028

Study Registration Dates

First Submitted

June 30, 2026

First Submitted That Met QC Criteria

July 8, 2026

First Posted (Actual)

July 10, 2026

Study Record Updates

Last Update Posted (Actual)

July 10, 2026

Last Update Submitted That Met QC Criteria

July 8, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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