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This study assessed the feasibility and preliminary efficacy of an online-assisted, occupational therapist-delivered, cognitive-behavioral therapy intervention to promote physical function in patients with knee osteoarthritis (KOA).Fifty-seven participants with KOA were randomized 2:1 to the Engage program (eight clinic-based sessions supported by online modules) or usual care. Using analysis of covariance, we estimated Engage's effect on physical function (Western Ontario and McMaster Universities Osteoarthritis Index's Physical Function subscale [WOMAC-PF]) at 6 mo.Data were analyzed on 46 completers. Engage was associated with a small effect (η2 = 0.01) on the WOMAC-PF. More Engage participants than controls reported much or very much improvement (45% vs. 13%; p = .03). Satisfaction was high, and 30 of 31 participants attended six sessions or more.An online-supported cognitive-behavioral program for people with KOA delivered by occupational therapists is feasible and may contribute to improved physical function.A web-supported cognitive-behavioral program for people with osteoarthritis delivered by occupational therapists was found to be feasible and may contribute to improved physical function.