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Effectiveness of a health promotion programme for long-term unemployed subjects with health problems: a randomized controlled trial
  1. M Schuring1,
  2. A Burdorf1,
  3. A J Voorham2,
  4. K der Weduwe2,
  5. J P Mackenbach1
  1. 1 Department of Public Health, Erasmus MC, Rotterdam, Netherlands;
  2. 2 Municipal Health Service GGD Rotterdam, Rotterdam, Netherlands
  1. * Corresponding author; email: a.burdorf{at}


Background: Employment status is an important determinant of health inequalities. Among unemployed persons a poor health decreases the likelihood of re-employment.

Methods: A randomized controlled trial with 6 months follow up among unemployed persons with health complaints receiving social security benefits from the city of Rotterdam, the Netherlands. In total, 456 persons were assigned to the control group and 465 persons 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: Enrollment in the intervention programme was 65% and 72% completed the programme with over 70% attendance to 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: The intervention programme aimed at promotion of physical and mental health of 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. It cannot be recommended to implement this particular health programme.

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