Physical Activity Counselling and Exercise Referral Increases Total Physical Activity in Long Term Unemployed Individuals: A Controlled Accelerometer Trial

Introduction Physical activity is seen as an integral component of a healthy lifestyle and has the potential to produce significant health benefits amongst individuals (Pedersen & Saltin 2006). It therefore plays a major role in the field of public health and primary prevention. Compared to the general population, unemployed persons show higher levels of physical inactivity and less physical activity (Pockrandt et al. 2007). For this and other reasons like e.g. unhealthy eating, smoking or substance abuse unemployment is associated with a greater health risk that additionally rises with increased duration of unemployment (Hollederer 2011). Therefore, a sports medical service of physical activity counselling and exercise referral was established at regional job centres to refer older unemployed persons to existing local exercise for health programs. The aim of this accelerometer study is to assess the change in physical activity following standardised physical activity counselling and exercise referral. A secondary focus lies on the changes in subjective health outcomes such as health and fitness status in elderly long-term unemployed persons over 50 years of age.

Methods A sample of 51 long-term unemployed persons over 50 years received physical activity counselling and exercise referral to attend local exercise for health programs at no charge for the next months. Further 21 unemployed persons and 17 employed persons, defined as control groups with no counselling nor exercise referral, were included. Physical activity levels of all 89 participants were measured over 7 consecutive days prior to and 12 weeks after counselling by biaxial accelerometer (ActiGraph GT1M).

Results Overall 58 persons completed pre/post measurements. Participants who started exercising increased their amount of moderate to vigorous physical activity (MVPA) from 26 ± 14 to 35 ± 25 minutes/day as well as total physical activity from 207 ± 86 to 288 ± 126 counts/minute significantly. At baseline, employed persons were more active than unemployed persons. Subjective health status decreased significantly in the unemployed control group after 12 weeks.

Discussion Unemployed persons are less active and less healthy compared to employed study sample. Unemployed persons who are willing and motivated to change physical activity behaviour benefit from physical activity counselling and exercise referral and increase MVPA to a health promoting level according to the guidelines. Physical activity inequalities could be reduced.

References Hollederer, A (2011). Unemployment and health in population of Germany. Journal of Public Health 19, 3:257-268 Pedersen, BK; Saltin, B (2006). Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports: 16 (Suppl. 1): 3–63 Pockrandt, C et al. (2011). Health Behaviour and Health-Risk Behaviour among Job-Seekers: A Screening at an Employment Agency [in german]. Gesundheitswesen; 69: 628– 634