150 Chapter 5 stakeholders is that contextual factors in relation to the prevention of health problems among employees with a lower SEP were discussed with stakeholders on organizational and socio-political level. The perspective of employees with a lower SEP is missing, while literature shows that stakeholders may hold other, or even more negative views on employees, than employees themselves (48, 49). A last limitation is that factors related to the content of interventions and potential users of interventions (e.g. occupational health professionals) were not investigated, but may in practice interfere with organizational and socio-political factors. For example, the degree to which the user is able to use the intervention in daily practice, may influence the degree to which organizations are willing to support implementation. Implications for research and practice Due to the difficulty to solve problems on multiple life domains among employees with a lower SEP, further research is needed on how organizations can adequately reach and support lower SEP employees with problems on multiple life domains. Furthermore, in this study employees with a lower SEP consisted of people with a regular job. However, employees with an even lower SEP, such as precarious workers or without a job, possibly have more problems on multiple life domains. Therefore, further research is also needed on the perspectives of stakeholders on employees with an even lower SEP. In addition, it should be explored which stakeholder could best deliver preventive interventions that consider problems on multiple life domains. Currently, the responsibilities are unclear, forming a situation wherein nobody feels responsible for dealing with problems on multiple life domains. Many different stakeholders, both in occupational and curative healthcare, are involved in dealing with these problems, but to effectively address problems on multiple life domains improvement in collaboration between these stakeholders is needed. To achieve this, reorganization of the Dutch healthcare system may be required towards more integrated care (29), wherein an employee is not dependent on the services of an employer and focus is on functioning of an individual in all life domains. Integrated care also has implications for the financial systems of both occupational and curative healthcare. Thus, to further improve collaboration the government needs to explore on how to financially bring these systems together or to financially compensate collaboration. Although, these separated healthcare systems make it difficult to effectively address problems on multiple life domains in the Netherlands, this may also be a problem that needs more attention in other countries. For example, countries wherein GPs are certified to give advice on sick leave also experience difficulties to assess the functioning of an individual in all life domains (32). Therefore, recommendations in this study to address problems on multiple life domains may also apply to other countries. This study also showed that it is very hard to convince employers to invest in prevention. If we want employers to invest more in prevention, more
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