The outcomes of the previous RCTs and the
implementation study are comparable, and indicate
ecological validity of both programmes (Glanz
et al., 1997). Ecological validity means the ability
of programmes, tested under controlled conditions,
to produce comparable outcomes in real-life conditions.
In particular, the decrease of pain is a noticeable
effect. Pain is an indicator of perceived quality of
life and a reason to consult the GP.
We identi®ed two explanations for the clinical
and behavioral outcomes. The process evaluation