Inclusion Criteria:  Community-dwelling English-speaking Physician diagnosed knee osteoarthritis Knee pain that occurs almost daily for at least the past 3 months and is moderate to severe in intensity Knee pain-related difficulty with walking or climbing stairs resident of a rural county  Exclusion Criteria:  cognitive impairment determined by a Mini Montreal Cognitive Assessment score of <11 any of the following in the past 6 months: cancer requiring treatment (except for non- melanoma skin cancer), heart attack, stroke, hip fracture, hip/knee replacement, spinal surgery, heart surgery, deep vein thrombosis, or pulmonary embolus; and temporary exclusions hospitalization within the last month ≥3 falls within the past month