108 Chapter 4 the intervention were interviewed and data was collected until no new themes emerged in the interviews. Unfortunately, no information was collected on OHP characteristics (e.g., sector and size of organization). This could have given more insight in facilitators and barriers for implementing Grip on Health. Implications for research and practice For OHPs to successfully deliver the intervention, it is important that they are able to preventively reach lower SEP workers for the Grip on Health intervention. From this study we learned that OHPs should make use of additional methods, e.g. preventive health examinations, to reach workers preventively. Some OHPs in this study stated that health professionals in curative healthcare could also deliver this intervention, because they are better able to reach lower SEP workers with problems on multiple life domains. GPs are often the first health professional for workers to discuss their health complaints and workers make little use of the opportunity to visit an OHP preventively (9). Therefore, further research should explore how professionals from outside occupational health care can play a role in preventively reaching lower SEP workers or on how they can deliver this intervention. The MRC framework describes that context is one of the main aspects that affect implementation of interventions (12). In this study, factors on organizational and socio-political level made it difficult for OHPs to deliver the intervention in occupational health practice. A hindering factor for implementation is that employers eventually determine whether preventive interventions, such as Grip on Health, are delivered to workers. Hence, for OHPs to be able to deliver the intervention and to have sufficient time, cooperation or permission from the involved employer is essential. Another hindering factor is the strict separation in the Netherlands between occupational and curative healthcare, which caused difficulties for OHPs to involve professionals from outside the workplace in the intervention. To effectively solve problems on other domains than work, collaboration with professionals from outside the workplace may be needed. Hence, further research is needed on how this collaboration could be improved. This study also showed that lower SEP workers find it more difficult to take self-control. The Dutch government and society encourage workers to take self-control for health and sustainable employability (35). Lower SEP workers need adequate support from OHPs. However, OHPs in this study experienced difficulties with their role as a process leader, as they are used to take on the role of the expert and workers find it difficult to identify problems and/or solutions on their own. Hence, education of OHPs needs to focus more on how to enhance self-control among (lower SEP) workers.
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