149 Context analysis of interventions among lower socioeconomic position employees in which employees may be unfamiliar with the preventive role of OPs (40). GPs also have limited time and expertise (32), and therefore the option for OPs to collaborate with other health professionals that are more accessible to solve problems on multiple life domains should be further explored. Literature also shows that employees may have a negative attitude towards OPs (40, 41). They are still insufficiently convinced of the OPs independence and see them as someone that is on the side of the employer as they are contracted and paid by employers (29, 40, 41). In contrast, employees in Finland are very satisfied with the services of an OP and visiting an OP is more common than visiting a GP, partially due to good accessibility of OPs (42, 43). Possible options that may change the attitude of employees towards OPs, improve the accessibility of OPs and the collaboration with other health professionals are: (1) integrate an OP or other professional specialized in work-related health problems in curative healthcare, or (2) organize healthcare around an individual person (29, 31, 39). Supervisors in this study were also considered important for the early identification of employees at risk. Supervisors have regular contact (sometimes daily) with their employees and could therefore be the first person to notice whether an employee is at risk and refer them to an OHP at an early stage. Multiple studies showed that supervisor support is an important resource for health and well-being at work (44, 45). Supervisors that support employees to overcome health-related problems could violate the privacy regulations (46), but according to some stakeholders in this study this legal barrier was not seen as a barrier in practice, showing that the privacy regulations with regard to problems on multiple life domains are unclear. Other stakeholders in this study described that this may also result in unwanted situations for employees, because of the hierarchical relationship between an employee and supervisor. Whether supervisors can discuss health-related problems with their employees strongly depends on the organizational culture, and the relation between supervisors and employees (47). Strengths and limitations This qualitative study provided in-depth information about organizational and socio-political factors in occupational health practice among different stakeholders. Different contextual factors were identified, which provide valuable information for future implementation of preventive interventions that consider multiple life domains among employees with a lower SEP. Furthermore, this study seems context specific, but factors found in this study were also found in studies conducted in other countries, thus suggesting transferability of findings. A limitation of this study is that stakeholders were partially recruited by the use of snowball sampling, which could result in a sample of stakeholders that were already interested in the topic of this study and may hold more positive views on their own role in implementation. Another limitation related to the sample of 5
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