246 Chapter 8 for the employability of workers themselves, and in light of staff shortages also for society. Still, the use of definitions to distinguish certain groups may help researchers or decision makers to develop interventions that better align with the characteristics and needs of certain groups. General interventions are likely to be less effective, as they are not well adapted to the specific needs of workers for whom the intervention is intended (4) and may even increase health inequalities (5). However, defining workers according to their SEP or work disability may not justify the complexity of factors influencing their health. As was described in the introduction, factors that may negatively influence their health, besides health care and healthy lifestyle, can according to the World Health Organization (WHO) be summarized into the social determinants of health (SDH) (6). SDH, such as income, having a job and healthy working and housing conditions, seem to be more important than health care and a healthy lifestyle for improving health. In line with this reasoning, the Participatory Approach in this thesis was adapted to address and solve problems on multiple life domains. Therefore, we may need to put less emphasis on putting workers in certain boxes and focus more on a combination of SDH, instead of focusing on specific groups. Methodological considerations In the following section the main methodological concerns of this thesis are discussed: 1) indicators for workers with a lower socioeconomic position, 2) recruitment and participation of workers in a vulnerable position, and 3) study designs to evaluate interventions in practice. Indicators for workers with a lower socioeconomic position For workers with a lower SEP, the term ‘SEP’ refers to social and economic factors that influence the position of individuals or groups within society, often determined by occupation, education, or income level (2). Other indicators for the SEP are the amount of material circumstances or possessions of an individual, or the social and/or economic circumstances of where people live (7). Indicators for the SEP are often related and substantially overlap, meaning that a higher level of education usually leads to better jobs and a higher income. Therefore, one measure is often used as a proxy to determine SEP. However, it’s not always that simple, as the indicator used to determine whether someone has a low or high SEP does not always match other social and/or economic factors of an individual. For example, a construction worker who could be identified as a worker with a lower SEP, can still have a high income. Otherwise, a person with a lower educational level could also be identified as a worker with a lower SEP and can still obtain extra qualifications during their working career and have a high income. According to
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