Behavioural support interventions to promote physical activity in osteoarthritis care: a scoping review

Introduction Physical activity (PA) is crucial for adults with osteoarthritis (OA) or who have received a total joint prosthesis (TJP), yet participation remains low. Behavioural support, such as PA counselling, may help increase PA. This scoping review mapped and characterised behavioural support interventions targeting PA in adults with OA or TJP, and summarised evidence on effectiveness and user experiences. Methods PubMed, Embase, CINAHL, PsycINFO, and Web of Science were searched (updated September 2025). Studies were eligible if they (1) included adults (≥18 years) with OA or TJP, (2) described interventions including interactive behavioural support aimed at increasing PA or related determinants, (3) reported PA levels, determinants or user experiences, and (4) were published in English. Data were extracted using a template informed by the Behaviour Change Intervention Ontology, and Behaviour Change Techniques (BCTs) were coded using the updated BCT taxonomy. Results Thirty-four unique interventions were included. Most targeted adults with knee OA in high-income countries, predominantly involving white, community-dwelling females. Interventions varied in delivery, intensity, and use of co-interventions, such as exercise programmes (53%) or wearable activity trackers (38%). Counselling was often delivered individually (62%) by trained providers (41%). Approximately 44% of interventions were explicitly informed by behaviour change theories and most commonly applied BCTs included goal setting (94%), delivering support (85%), and goal strategising (76%). Reported effects on PA and PA-related determinants were mixed, and outcome measures were heterogeneous. Qualitative findings indicated that participants valued personalised support, motivation, and accountability, while barriers included time constraints, and declining adherence after structured support ended. Conclusions Behavioural support interventions for PA in adults with OA or TJP show substantial variation in design and delivery. While several potentially relevant intervention features and user experiences were identified, heterogeneity in intervention design and outcome measures limits firm conclusions about effectiveness and highlights important evidence gaps.