The Influence of a Health Promotion Program on Health and Paid Employment Among Long-Term Non-employed Individuals in the Netherlands.

The study was not randomised. Exercise Works participants were referred by employment professionals, while control participants were recruited through employment professionals, waiting rooms, and Facebook groups. Eligibility was broadened from social assistance recipients to non-employed people living in the Netherlands because of low enrollment. Many participants did not complete follow-up. Only 64 Exercise Works participants and 61 control participants completed the 12-month questionnaire. The two groups differed at baseline, including age, birthplace, children, and education. Exercise Works combined physical exercise, lifestyle education, and individual coaching, so the contribution of any single component cannot be separated. The control group received usual employment services and may also have participated in other re-employment programs. Interviews included only 11 coaches, 20 participants, and 10 employment professionals, and social desirability or selection bias may have affected the positive perceptions. COVID-19 affected recruitment, program delivery, and participant wellbeing, and contributed to reduced study power.

The paper states the funder was ZonMw. No other conflict of interest or author declaration is provided in the supplied text.

Do not read the within-program improvements in health, work ability, and employment as proof that Exercise Works works. The changes were not significantly different from the control group, and the program combined physical activity, lifestyle education, and coaching, so no single component can be credited.