131 Context analysis of interventions among lower socioeconomic position employees Introduction In developed countries there are important health differences between people with a lower and higher socioeconomic position (SEP) (1), which is determined by occupation, education and/or income (2). People with a lower SEP have a higher risk for health problems, which negatively affects their work participation and increases their risk for premature dropout from the labor market (3, 4). This points out the importance of preventive interventions that actively support employees with a lower SEP to solve their health problems, who are defined as workers with manual labor (e.g. construction worker) or with lower educated and/or lower income occupations (e.g. administrative worker or truck drivers). In the past decades, many interventions have been developed to prevent health problems among employees with a lower SEP (5,6,7,8). These interventions mainly focused on work and lifestyle related health problems, while health problems among employees with a lower SEP often result from an interplay of problems on multiple life domains, such as unfavorable psychosocial factors and unhealthy living conditions (2, 9, 10). A complex interplay of problems among employees with a lower SEP, asks for an intervention that can tackle multiple problems in various life domains. For this, the Grip on Health intervention was developed to support employees with a lower SEP to improve their health from a broader perspective, and thereby prevent health problems. This intervention is based on the Participatory Approach (PA) (11) and identifies and solves problems on multiple life domains that affect healthy functioning at work. The current study builds on a pilot study in which the Grip on Health intervention was implemented in occupational health practice and the implementation process was evaluated (not published yet). The process evaluation focused on factors on the level of the intervention itself (i.e. design and content of the intervention) and the users of the intervention (i.e. employees who received the intervention, and occupational health professionals (OHPs) who facilitated the intervention). The results of the process evaluation showed that the intervention was perceived as relevant by the users of the intervention, but difficult to implement in practice. The next step is to investigate contextual factors (i.e. organizational and socio-political factors) (12, 13). This can provide more insight into the implementation process of preventive interventions that takes into account multiple life domains among employees with a lower SEP. Research shows that implementation is much more dependent on contextual factors, as opposed to the design and content of interventions (14,15,16). Contextual factors are less easy to adjust or influence, and therefore require careful consideration prior to implementation. This means that the implementation of interventions often requires a system approach (17, 18), wherein 5
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