132 Chapter 5 the complexity of structures and systems in occupational health practice are taken into account. Therefore, this study examined the organizational and sociopolitical context for implementation of preventive interventions that consider multiple life domains among employees with a lower SEP, and explored contextual factors that affect implementation of these type of interventions. Methods Study Design This study used a qualitative, explorative design to obtain in-depth information on the organizational and socio-political context for implementation of preventive health interventions that consider multiple life domains among employees with a lower SEP. The information was obtained by conducting semi-structured interviews among different stakeholders in the organizational and socio-political context of occupational health practice. The Medical Ethics Committee of the VU University Medical Center approved the study protocol and decided that the Medical Research Involving Human Subjects Act does not apply to this study. All stakeholders signed informed consent before participation. Context In the Netherlands, The Working Conditions Act forms the basis for general rights and duties for employers and employees to ensure a safe and healthy working environment. All employers have the obligation to seek support on health and safety from OHPs, that provide professional advice and guidance for a safe and healthy working environment (19). In case of long-term sickness absence of an employee (more than 6 weeks) there is a legal obligation for employers to ask for professional advice from an occupational physician (OP). Also, not sick listed employees have the possibility by law (Working Conditions Act) to ask for advice from an OP without permission from their employer. Furthermore, employers are obligated to offer employees an occupational health examination and evaluate the risks for health and safety at the workplace. OHPs can either be self-employed or employed by occupational health services (OHSs). OHSs or self-employed OHPs offer various types of contracts to employers, such as rather basic contracts in which only advice is provided on a single occasion at the request of the employer, up to contracts with continuous in-house services of multiple OHPs. Moreover, employers can also have an in-house OHS. The Works Council or employees’ representatives must approve the content of contracts with the OHS. In practice, the content of these contracts varies widely, however there are still employers that do not fulfill the Working Conditions Act or do not have any contract at all (20, 21).
RkJQdWJsaXNoZXIy MTk4NDMw