248 Chapter 8 contact with workers on long-term sick leave. Lower SEP workers do not often tend to seek contact with an OHP for prevention. This is in line with other research, showing that vulnerable populations are less likely to seek contact with a doctor, as they have a lower level of trust in doctors (11). In case they start experiencing health complaints, they will primarily seek contact with a general practitioner. OHPs could be seen as someone that works for the employer (12), as was also described in chapter 3. Workers may not always be aware of the preventive and independent role of OHPs and that these professionals can also help workers with problems outside the workplace. Moreover, lower SEP workers may not always prefer that an intervention, to address problems on multiple life domains is provided by their employer. The results in chapter 3 and 5 showed that workers with a lower SEP are not used to and/or may not like to talk openly about their problems outside the workplace, as they may want to keep their work and private life separate (13). A lower health literacy among workers with a lower SEP may be another reason to not visit a doctor. Patients’ ability to feel the need and to subsequently seek contact with a doctor was affected by a lower health literacy (14). Preventively this may be even a larger problem, as a direct reason to visit a doctor is not always present, and workers with problems on multiple life domains may have many things going on in their lives, such as financial problems or caring responsibilities (4). In contrast, in the evaluation of ‘Mentorwijs’ we did succeed to recruit a sufficient number of workers with a work disability to participate in the study. These workers were mainly recruited through their supervisor or employer. Supervisors and employers are often (daily) in contact with their workers, which could make it easier to recruit workers. Whereas the OHPs in our study reported that they often do not have any contact with most workers, except when workers are on sick leave or with workers who were referred to an OHP. Moreover, participation for workers with a work disability in the ‘Mentorwijs’ evaluation took very little time and effort, as the researchers visited the workplaces and workers could participate during work hours in which they only needed to fill in a short questionnaire or participate in an interview. Nothing else was expected from workers, as supervisors received the ‘Mentorwijs’ training and were asked to implement the newly acquired knowledge and skills in the daily guidance of workers with a disability. Reducing the burden for participants was also identified as a success factor in another study on how to successfully recruit adults with a low SEP (15). Conversely, the Grip on Health intervention required from workers to openly discuss their healthrelated problems not only with the OHP but also with their supervisor or another stakeholder from outside the workplace. However, not all lower SEP workers want to talk openly about their problems in- or outside the workplace with an OHP or supervisor, making it more difficult to recruit these workers.
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