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Effectiveness of a health promotion programme for long-term unemployed subjects with health problems: a randomised 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, The Netherlands
  2. 2
    Municipal Health Service GGD Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Dr A Burdorf, Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands; a.burdorf{at}


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.

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  • Funding Funding for this study was provided by the Public Health Fund (Fonds OGZ) of The Netherlands (reg. no. P161).

  • Competing interests None declared.

  • Ethics approval The study was approved by the medical ethics committee of the University Medical Center, Rotterdam Erasmus MC, The Netherlands.

  • Provenance and peer review Not commissioned; externally peer reviewed.