Effectiveness of a health promotion programme for long-term unemployed subjects with health problems: a randomised controlled trial

• Published in: Journal of epidemiology and community health (1979) Vol. 63; no. 11; pp. 893 - 899
• Main Authors: Schuring, M, Burdorf, A, Voorham, A J, der Weduwe, K, Mackenbach, J P
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.11.2009; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adaptation, Psychological; Adolescent; Adult; Biological and medical sciences; Community health; Education; Employment; Exercise; Female; General aspects; Health care outcome assessment; Health problems; Health promotion; Health Promotion - methods; Health Status Disparities; Humans; Internal-External Control; Intervention; Job hunting; Male; Medical sciences; Mental Health; Middle Aged; Miscellaneous; Mortality; Motor Activity; Netherlands; Pain; Physical fitness; Program Evaluation; Psychoeducational intervention; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of Life; Questionnaires; Research reports; Self esteem; Time Factors; Unemployment; Unemployment - psychology; Young Adult; Netherlands; Human; Medicine; Sanitary program; Efficiency; Health promotion; Clinical trial; Long term; Public health; long-term unemployment; perceived health; health promotion; HEALTH PROMOTION FQ; UNEMPLOYMENT & HEALTH; randomized controlled trial
• ISSN: 0143-005X; 1470-2738; 1470-2738
• DOI: 10.1136/jech.2008.080432

Background:Employment status is an important determinant of health inequalities. Among unemployed people, poor health decreases the likelihood of re-employment.Methods:A randomised controlled trial with 6 months’ follow-up among unemployed people with health complaints receiving social security benefits from the city of Rotterdam, The Netherlands. In total, 456 people were assigned to the control group and 465 people to the intervention group. The intervention consisted of three sessions weekly over 12 weeks. One session a week was focused on education to enhance the ability to cope with (health) problems, and two weekly sessions consisted of physical activities. The primary outcome measures were perceived health, measured by the Short Form 36 Health Survey, and psychological measures mastery, self-esteem and pain-related fear of movement. Secondary outcome measures were work values, job search activities and re-employment.Results:Enrolment in the intervention programme was 65%, and 72% completed the programme with over 70% attendance at all sessions. The intervention had a good reach among subjects with lower education, but had no effect on mental and physical health, mastery, self-esteem and pain-related fear of movement. Participation in the programme had no influence on work values, job search activities or re-employment.Conclusion:This intervention programme aimed at the promotion of physical and mental health in unemployed people with health complaints did not show beneficial effects. The lack of integration into regular vocational rehabilitation activities may have interfered with these findings. This particular health programme cannot be recommended for implementation.