ArticleImplementation science communications2026
Bridging evidence and care for knee osteoarthritis in China: a randomized feasibility trial with RE-AIM-guided process evaluation of the PEAK-CHN model of care.
Article in Implementation science communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Lower chronic neck-back with higher planetary health diet adherence.Frontiers in nutrition · 2026Article
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5 authors.
Funding
Abstract
backgroundExercise therapy and education are recommended first-line treatments for knee osteoarthritis (KOA), yet uptake in routine care remains limited globally, including in China, which bears the largest disease burden. Barriers include limited access to allied health services, low awareness of guideline-based care, and poor integration across care sectors. To address these challenges, we developed PEAK-CHN (Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis in China), a multidisciplinary implementation model covering care content, care delivery, and care providers. This study aimed to implement PEAK-CHN in real-world settings and evaluate its feasibility and early implementation outcomes using the RE-AIM framework.
methodsWe conducted a parallel-group, two-arm randomized feasibility trial (n = 73; mean age 66.4 years; 65.8% female). Participants were randomized to receive either PEAK-CHN or usual care. The intervention targeted three components: (1) care providers, a multidisciplinary team trained through workshops and online modules; (2) care content, including five structured telehealth consultations, personalized home-based strengthening exercise, tailored education, daily behavior-change messaging, and comorbidity management; and (3) care delivery within a policy-supported primary care setting using a hybrid model. Usual care was documented via the local health insurance system. Primary outcomes assessed feasibility (recruitment, adherence, engagement, staff workload, and preliminary costing). Secondary outcomes assessed clinical, psychological, and behavioral changes at baseline, 3, and 6 months. Semi-structured interviews (n = 11) explored participant experiences.
resultsRecruitment was completed within four weeks with a 63% enrollment rate. Retention at 6 months was 97%. All intervention participants completed all five telehealth consultations, and 90% achieved the prescribed exercise dose of at least three sessions per week. Delivery was feasible within routine workflows, with consultations averaging 30 min and no intervention-related adverse events. Participant satisfaction was high (mean 8.8/10), and most rated key components as helpful. Exploratory analyses suggested potential improvements in pain, function, and self-efficacy compared with usual care.
conclusionsPEAK-CHN was feasible and acceptable in a policy-supported primary care setting in China and can be delivered using existing workforce and digital infrastructure. Findings inform the design of a future full-scale trial and broader implementation evaluation.
trial registrationChinese Clinical Trial Registry, https://www.chictr.org.cn/ , ChiCTR2400091007, registered on 18/1/2024.
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