Three types of primary health-care providers were eligible for participation: commercial PhysioSport Centers, local health centers and the health service departments of home-care organizations. The home-care organizations provide long-term, home-based care to chronically ill, handicapped and elderly in need.
Four pilot regions were selectedÐtwo urban and two semi-rural areas in western and central Netherlands. The project budget was sufficient for a maximum of 20 providers. Individual providers were contacted by telephone. Each provider was assigned a contact person who received instruction training and written guidelines for the local implementation of the programmes,and manuals for programme delivery. Because ®delity and completeness of programme delivery are predictors of effectiveness(Rossi et al., 1999), both the implementation guidelines and the programme manuals consisted of instructions for programme planning and delivery. Providers could adjust the programme content and procedures, provided that they did not change the core components. Allowing providers to make adjustments, e.g. a certain degree of programme refinement, enhances commitment, and ensures complete and conscientious delivery of the core components (Rogers, 1995).