Osteoarthritis of KneeCAPPANCT06734052
Computer-guided Action Planning to Support Physical Activity (CAPPA) for Employees With Chronic Knee Symptoms
A study testing CAPPA and Health education in people with Osteoarthritis of Knee and Knee Pain Chronic, run by Marquette University at 1 site in United States.
Trial summary
The goal of this clinical trial is to learn if a brief health coaching intervention based on an approach known as brief action planning + Fitbit can increase physical activity in employees with chronic knee symptoms who work for Advocate Aurora Health. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Osteoarthritis of Knee, Knee Pain Chronic
- What is being tested?
- CAPPA and Health education
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 39 participants
- Where
- 1 siteUnited States
- Study dates
- 12 Aug 2024to 3 Feb 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age >/= 18 years
- Employed at a participating workplace
- Report pain, aching or stiffness in or around the knee over the past 12 months
- Report chronic pain, aching or stiffness in or around knee on most days for at least a month over the past 12 months
- Have access to a device with active internet access to view study dashboard
Who cannot join
- Currently meet CDC PA guidelines (per baseline accelerometer assessment)
- Have had a joint replacement on the symptomatic side or plan to have one within the next year
- Have serious medical conditions or impairments that, in the investigators' view, would create safety concerns in the trial such as uncontrolled hypertension (SPB>160 or diastolic ≥ 100 mm), or symptoms of unstable cardiac or pulmonary disease in the past month ( using the 2021 Physical Activity Readiness Questionnaire for Everyone (PAR-Q+)
- Are unable to walk 50' with or without an assistive device
- Plan to relocate from the region within the next year
- Have limited English literacy
- Carry a diagnosis of inflammatory arthritis
Trial locations and contacts
1 site in 1 country.
About this study
The goal of this clinical trial is to learn if a brief health coaching intervention based on an approach known as brief action planning + Fitbit can increase physical activity in employees with chronic knee symptoms who work for Advocate Aurora Health. The main questions it aims to answer are:
- Will a greater proportion of people in the health coaching intervention increase physical activity to at least 150 minutes of moderate-to-vigorous physical activity per week than a group of people with an attention-control intervention (Fitbit+health education coaching)?
- Can we predict who will not increase physical activity levels to at least 150 minutes of moderate-to-vigorous physical activity per week by the end of the study (3 and 6 months) based upon Fitbit data captured over the first four weeks?
Read more
Researchers will compare a health education coaching intervention + Fitbit to see if providing a Fitbit + attention control will increase physical activity to at least 150 minutes of moderate-to-vigorous physical activity per week among members of the attention-control group.
Participants will engage in
- Online study orientation and question and answer session
- Three assessment sessions (baseline, 3 months, 6 months)
- A 12 week intervention with no less than four (4) and no more than twelve (12) health coaching sessions. Physical activity health coaching will make action plans for health coaching. Health education coaching will focus on educating participants on non-physical activity factors related to a comprehensive management of chronic knee symptoms, such as managing fatigue, sleep hygiene, mindfulness, etc.
Read the detailed description
Chronic knee symptoms (CKS) are associated with pain, loss of independence, and increased mortality. Rates of CKS are increasing, fueled by an aging, obese, and sedentary society. Because CKS first presents in working age adults, it is a major cause of work disability and work productivity loss.
Being physically active improves the health of adults who have ongoing (chronic) complaints of knee pain, knee stiffness, or challenges with moving around. Physical activity helps decrease pain, improve stiffness, and improve physical function as it relates to the knee. It also helps people improve their general health. Unfortunately, it is hard for many people to become more physically active. Physical activity can be inconvenient and uncomfortable for many people, and people who join physical activity programs often drop out of them after a short time (3-6 months). However, people are more likely to reach their physical activity goals if they work with a health coach who supports the process.
Health coaching often includes a combination of self-monitoring such as using smart devices to monitor outcomes plus the support of goal-directed behavior. Previous research has found that Fitbit tracking can improve behavior for some people who have CKS but not for others. Whereas we know people can receive benefit from coaching, the exact amount of coaching needed remains unknown. Discussion with employee stakeholders have informed our intervention desire as they have asked for a low resource form of coaching available through the workplace. The potential exists to support employees with CKS using an acceptable, low-resource coaching strategy.
The goal of this program is to test a brief, scalable PA coaching intervention that can assist employees with CKS attain and maintain healthy PA behavior in worksites in the Midwest. CAPPA is a 12-week pilot randomized controlled trial that will 1) use computer-guided action-planning behavioral intervention to support employees in making physical activity action plans for their health, 2) use data transmitted from a personal fitness tracker (Fitbit) to support coach and employee knowledge about PA performance, and 3) Inform on optimal step up times for participants who do not substantially increase PA. The CAPPA system will put PA feedback in a Movement Dashboard to support study participants. The CAPPA intervention will primarily use video chat to attain and sustain healthy PA behavior across worksites at Advocate Aurora Health.
Follow-up measures of PA, pain and physical function are planned at treatment completion and three months following study completion. Specific aims are to: 1) Estimate the efficacy of the intervention to increase objectively measured physical activity, 2) Examine the feasibility, acceptability and sustainability of the CAPPA intervention for the respective workplaces, and 3) Inform the initial step up time for future stepped interventions among participants not substantially increasing their physical activity. This study leverages the combined clinical and technologic expertise of the members of the Physical Activity in Rheumatology Research group at Northwestern University, Northwestern's Arthritis Center Accelerometer unit, Marquette University's Behavior, Engagement and Technology Assessment Lab and Ubiquitous Computing Lab, and Advocate Aurora Health.
This research could have a tremendous impact on improving symptoms and quality of life for those with CKS and early KOA. If treatments are successful at Advocate Aurora Health they may be employed in the services they provide to other organizations.
- Conditions
- Osteoarthritis of Knee, Knee Pain Chronic
- Being tested
- CAPPA, Health education
- Keywords
- knee symptoms, physical activity, Fitbit, accelerometer, Health coaching, remote coaching
- Medical subject headings
- Osteoarthritis, Knee, Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CAPPABehavioural
See CAPPA arm description.
Health educationBehavioural
See health education arm description
| Study group | Role | What they receive |
|---|---|---|
| Computer-guided Action Planning to support Physical Activity (CAPPA) | Experimental | Participants in the CAPPA Arm receive a Fitbit and health coaching using Computer-guided Action planning. Coaches will utilize the coaching software within www.myactionplans.com to guide the coaching interaction and support physical activity plan development. The emphasis is this arm is to create plans that are person-centered and driven by the participant. The action planning process is grounded in the conversational style of motivational interviewing and follows Brief Action Planning as a self-management support style. Coaches in the CAPPA arm will also have access to a custom Movement Dashboard which that uses Fitbit data to plot daily physical activity. The dashboard is coach-facing and is used to support coach dialogue about physical activity.
There is scheduling flexibility: 4-12 visits over the 12-week period. Participants are strongly encouraged not to have a gap longer than three weeks between visits. Receives: Behavioral: CAPPA |
| Health education | Active comparator | Participants in Arm 2 receive a Fitbit and health education delivered by a coach. Health education selects topics from the chronic disease self-management program that address common features of living with a chronic condition. Arm 2 avoids making specific plans and avoids discussion of physical activity. The emphasis in this arm is in providing education.
There is scheduling flexibility, 4-12 visits over the 12-week period. Participants are strongly encouraged not to have a gap longer than three weeks between visits to keep the content fresh. Receives: Behavioral: Health education |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of CDC-guideline based physical activity compliance
Proportion of people per treatment arm meeting CDC guidelines for aerobic physical activity. How many participants per group have achieved 150 minutes of weekly moderate-to-vigorous physical activity.
Measured: baseline, 3 month, 6month follow-up
Secondary outcomes (17)
Fitbit measured physical activity
Minutes of non-sedentary activity/day; Minutes of light, moderate-vigorous physical activity/day
Measured: baseline, week 1, week 2, week 3, week 4.
Tampa Scale of Kinesiophobia
A self-report measure with 17 items used to measure fear of movement/(re)injury in chronic pain patients
Measured: Baseline, 3 months, 6 months
Michigan Body Map
The Michigan Body Map (MBM) is a self-report measure to assess body areas of chronic pain. The MBM can also quantify the degree of widespread body pain when assessing for centralized pain features.
Measured: baseline, 3 month, 6 month follow-up
Self-efficacy for physical activity
This scale is a self-report of exercise self-efficacy.
Measured: baseline, 3 month, 6 month follow-up
Numeric Pain Rating Scale
The NPRS is an 11-point scale scored from 0-10:
- "0" = no pain
- "10" = the most intense pain imaginable
Measured: baseline, 3 month, 6 month follow-up
WOMAC pain and physical function sub-scales
The WOMAC subscales of pain (five questions), and physical function (17 questions). The subscale scores can vary, with pain ranging from 0 to 20 points; and physical function, 0 to 68 points. Higher scores represent worse pain and functional limitations.
Measured: baseline, 3 month, and 6 month follow up
PROMIS self reported outcomes
Computer-adaptive tests of self-reported physical function, pain interference, fatigue, and positive affect.
Measured: Baseline, 3 month, 6 month follow-up
Performance-based outcomes - Timed up and Go
Timed up and go - time it takes to stand from chair, walk 3 meters, return to chair and sit. measured in seconds
Measured: baseline, 3 month, 6 month follow-up
Performance-based outcomes - 4 meter walk
Time it takes to walk four (4) meters. Measured in seconds
Measured: baseline, 3 month, 6 month follow-up
Performance-based outcomes - 5x sit-stand
Time it takes to complete five (5) repetitions of the sit to stand movement. Timed from leaving the surface of the seat on the first sit-stand movement to contacting the seated surface on the fifth sit-stand movement.
Measured: baseline, 3 month, 6 month follow-up
Feasibility measure - recruitment rate
Number of participants engaging in screening process following targeted email or onset of recruitment campaigns.
Measured: 3 month follow-up
Feasibility measures - consent rate
The proportion of eligible individuals who agreed to participate.
Measured: 3 month follow-up
Feasibility measures - drop out rate
Proportion of individuals who dropped out of the study at different stages of the study.
Measured: 3 month follow-up, 6 month follow-up
Feasibility measures - adherence to protocol
adherence to protocols - proportion of people who completed at least 4 coaching visits.
Measured: 3 month follow-up
Feasibility measures - personnel retention
number of personnel that left the study
Measured: 3 month follow-up, 6 month follow-up
Feasibility measures - fidelity
Proportion of reviewed coach recordings that followed prescribed coaching method.
Measured: 3 month follow-up
Feasibility measures-qualitative
Qualitative sentiment regarding the ability of the coaching approach to integrate in an individual's work life.
Measured: 3 month follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Dec 2024
- Study start12 Aug 2024
- Primary completion2 Feb 2026
- Study completion3 Feb 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Osteoarthritis of KneeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 39 participants (actual)
Sponsor and investigators
- Lead sponsor
- Marquette University
- Sponsor type
- University, hospital or other
- Collaborators
- Northwestern University, Rush University, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
- Responsible party
- Principal investigator, Daniel Pinto, Marquette University
- Investigators
- Daniel Pinto, PhD, Principal investigator, Marquette UniversityRowland W Chang, MD MPH, Principal investigator, Northwestern University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06734052
- Sponsor's protocol ID
- AR081007
- Other IDs
- 1R21AR081007-01A1
- Acronym
- CAPPA
- Status last verified
- Mar 2026
- First submitted
- 16 Nov 2024
- Last updated
- 1 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 1 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Computer-guided Action Planning to Support Physical Activity (CAPPA) for Employees With Chronic Knee Symptoms
- ClinicalTrials.gov ID
- NCT06734052
- Acronym / sponsor ID
- CAPPA / AR081007
- Conditions
- Osteoarthritis of Knee, Knee Pain Chronic
- Keywords
- knee symptoms, physical activity, Fitbit, accelerometer, Health coaching, remote coaching
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 39 participants (actual)
- Lead sponsor
- Marquette UniversityUniversity, hospital or other
- Collaborators
- Northwestern University, Rush University, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
- Study start
- 12 Aug 2024 (actual)
- Primary completion
- 2 Feb 2026 (actual)
- Study completion
- 3 Feb 2026 (actual)
- First posted
- 16 Dec 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to learn if a brief health coaching intervention based on an approach known as brief action planning + Fitbit can increase physical activity in employees with chronic knee symptoms who work for Advocate Aurora Health. The main questions it aims to answer are:
- Will a greater proportion of people in the health coaching intervention increase physical activity to at least 150 minutes of moderate-to-vigorous physical activity per week than a group of people with an attention-control intervention (Fitbit+health education coaching)?
- Can we predict who will not increase physical activity levels to at least 150 minutes of moderate-to-vigorous physical activity per week by the end of the study (3 and 6 months) based upon Fitbit data captured over the first four weeks?
Researchers will compare a health education coaching intervention + Fitbit to see if providing a Fitbit + attention control will increase physical activity to at least 150 minutes of moderate-to-vigorous physical activity per week among members of the attention-control group.
Participants will engage in
- Online study orientation and question and answer session
- Three assessment sessions (baseline, 3 months, 6 months)
- A 12 week intervention with no less than four (4) and no more than twelve (12) health coaching sessions. Physical activity health coaching will make action plans for health coaching. Health education coaching will focus on educating participants on non-physical activity factors related to a comprehensive management of chronic knee symptoms, such as managing fatigue, sleep hygiene, mindfulness, etc.
Detailed description
Chronic knee symptoms (CKS) are associated with pain, loss of independence, and increased mortality. Rates of CKS are increasing, fueled by an aging, obese, and sedentary society. Because CKS first presents in working age adults, it is a major cause of work disability and work productivity loss.
Being physically active improves the health of adults who have ongoing (chronic) complaints of knee pain, knee stiffness, or challenges with moving around. Physical activity helps decrease pain, improve stiffness, and improve physical function as it relates to the knee. It also helps people improve their general health. Unfortunately, it is hard for many people to become more physically active. Physical activity can be inconvenient and uncomfortable for many people, and people who join physical activity programs often drop out of them after a short time (3-6 months). However, people are more likely to reach their physical activity goals if they work with a health coach who supports the process.
Health coaching often includes a combination of self-monitoring such as using smart devices to monitor outcomes plus the support of goal-directed behavior. Previous research has found that Fitbit tracking can improve behavior for some people who have CKS but not for others. Whereas we know people can receive benefit from coaching, the exact amount of coaching needed remains unknown. Discussion with employee stakeholders have informed our intervention desire as they have asked for a low resource form of coaching available through the workplace. The potential exists to support employees with CKS using an acceptable, low-resource coaching strategy.
The goal of this program is to test a brief, scalable PA coaching intervention that can assist employees with CKS attain and maintain healthy PA behavior in worksites in the Midwest. CAPPA is a 12-week pilot randomized controlled trial that will 1) use computer-guided action-planning behavioral intervention to support employees in making physical activity action plans for their health, 2) use data transmitted from a personal fitness tracker (Fitbit) to support coach and employee knowledge about PA performance, and 3) Inform on optimal step up times for participants who do not substantially increase PA. The CAPPA system will put PA feedback in a Movement Dashboard to support study participants. The CAPPA intervention will primarily use video chat to attain and sustain healthy PA behavior across worksites at Advocate Aurora Health.
Follow-up measures of PA, pain and physical function are planned at treatment completion and three months following study completion. Specific aims are to: 1) Estimate the efficacy of the intervention to increase objectively measured physical activity, 2) Examine the feasibility, acceptability and sustainability of the CAPPA intervention for the respective workplaces, and 3) Inform the initial step up time for future stepped interventions among participants not substantially increasing their physical activity. This study leverages the combined clinical and technologic expertise of the members of the Physical Activity in Rheumatology Research group at Northwestern University, Northwestern's Arthritis Center Accelerometer unit, Marquette University's Behavior, Engagement and Technology Assessment Lab and Ubiquitous Computing Lab, and Advocate Aurora Health.
This research could have a tremendous impact on improving symptoms and quality of life for those with CKS and early KOA. If treatments are successful at Advocate Aurora Health they may be employed in the services they provide to other organizations.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Computer-guided Action Planning to support Physical Activity (CAPPA) | Experimental | Behavioral: CAPPAParticipants in the CAPPA Arm receive a Fitbit and health coaching using Computer-guided Action planning. Coaches will utilize the coaching software within www.myactionplans.com to guide the coaching interaction and support physical activity plan development. The emphasis is this arm is to create plans that are person-centered and driven by the participant. The action planning process is grounded in the conversational style of motivational interviewing and follows Brief Action Planning as a self-management support style. Coaches in the CAPPA arm will also have access to a custom Movement Dashboard which that uses Fitbit data to plot daily physical activity. The dashboard is coach-facing and is used to support coach dialogue about physical activity. There is scheduling flexibility: 4-12 visits over the 12-week period. Participants are strongly encouraged not to have a gap longer than three weeks between visits. |
| Health education | Active comparator | Behavioral: Health educationParticipants in Arm 2 receive a Fitbit and health education delivered by a coach. Health education selects topics from the chronic disease self-management program that address common features of living with a chronic condition. Arm 2 avoids making specific plans and avoids discussion of physical activity. The emphasis in this arm is in providing education. There is scheduling flexibility, 4-12 visits over the 12-week period. Participants are strongly encouraged not to have a gap longer than three weeks between visits to keep the content fresh. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Age >/= 18 years
- Employed at a participating workplace
- Report pain, aching or stiffness in or around the knee over the past 12 months
- Report chronic pain, aching or stiffness in or around knee on most days for at least a month over the past 12 months
- Have access to a device with active internet access to view study dashboard
Key exclusion criteria (7 listed)
- Currently meet CDC PA guidelines (per baseline accelerometer assessment)
- Have had a joint replacement on the symptomatic side or plan to have one within the next year
- Have serious medical conditions or impairments that, in the investigators' view, would create safety concerns in the trial such as uncontrolled hypertension (SPB>160 or diastolic ≥ 100 mm), or symptoms of unstable cardiac or pulmonary disease in the past month ( using the 2021 Physical Activity Readiness Questionnaire for Everyone (PAR-Q+)
- Are unable to walk 50' with or without an assistive device
- Plan to relocate from the region within the next year
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CAPPASee CAPPA arm description. | Behavioural | Computer-guided Action Planning to support Physical Activity (CAPPA) |
| Health educationSee health education arm description | Behavioural | Health education |
Primary outcome
Proportion of CDC-guideline based physical activity compliance
Time frame: baseline, 3 month, 6month follow-up
Proportion of people per treatment arm meeting CDC guidelines for aerobic physical activity. How many participants per group have achieved 150 minutes of weekly moderate-to-vigorous physical activity.
17 secondary outcomes
Fitbit measured physical activity
Time frame: baseline, week 1, week 2, week 3, week 4.
Tampa Scale of Kinesiophobia
Time frame: Baseline, 3 months, 6 months
Michigan Body Map
Time frame: baseline, 3 month, 6 month follow-up
Self-efficacy for physical activity
Time frame: baseline, 3 month, 6 month follow-up
Numeric Pain Rating Scale
Time frame: baseline, 3 month, 6 month follow-up
WOMAC pain and physical function sub-scales
Time frame: baseline, 3 month, and 6 month follow up
PROMIS self reported outcomes
Time frame: Baseline, 3 month, 6 month follow-up
Performance-based outcomes - Timed up and Go
Time frame: baseline, 3 month, 6 month follow-up
Performance-based outcomes - 4 meter walk
Time frame: baseline, 3 month, 6 month follow-up
Performance-based outcomes - 5x sit-stand
Time frame: baseline, 3 month, 6 month follow-up
Feasibility measure - recruitment rate
Time frame: 3 month follow-up
Feasibility measures - consent rate
Time frame: 3 month follow-up
Feasibility measures - drop out rate
Time frame: 3 month follow-up, 6 month follow-up
Feasibility measures - adherence to protocol
Time frame: 3 month follow-up
Feasibility measures - personnel retention
Time frame: 3 month follow-up, 6 month follow-up
Feasibility measures - fidelity
Time frame: 3 month follow-up
Feasibility measures-qualitative
Time frame: 3 month follow-up
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Apr 2026.
- Individual participant dataSharing planned: Yes
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Daniel Pinto, PhD principal investigator
Marquette University
Rowland W Chang, MD MPH principal investigator
Northwestern University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing CAPPA and Health education in people with Osteoarthritis of Knee and Knee Pain Chronic, run by Marquette University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 1 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Proportion of CDC-guideline based physical activity compliance (time frame: baseline, 3 month, 6month follow-up). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Apr 2026.