257 General discussion component in these contracts (36). A possible way of convincing employers to invest in prevention is by making structural changes in legislations, such as making prevention a bigger part of the Working Conditions Act. However, this also requires more surveillance and enforcing employers to comply with the legislation. Furthermore, research shows that many employers have a negative attitude towards prevention (35), which might hamper implementation of preventive activities (37). Thus, for extending preventive activities in practice we need to change the attitudes of employers towards prevention. For example, by providing employers more information about the (financial) benefits of prevention, and the potential costs of workers who are on sick leave (36). More research is needed on how to convince employers to invest in prevention; is the underlying explanation their negative attitude towards prevention, or are there other factors that limit the extent to which they invest in prevention? This type of research is even more relevant for the target group in this thesis, as employers tend to invest even less in workers in a vulnerable position. More knowledge on the benefits of preventive activities and preventive support would make it more feasible for OHPs to expand their preventive duties. Supervisors should also pursue a more active approach towards prevention in practice and a supportive work environment for workers in a vulnerable position. As results of this thesis indicated, supervisors could play an important role in early identification and referral of workers at risk to (health) professionals. For this, it is important that every supervisor is trained in the importance of sustainable employability, and that they stimulate workers to make use of preventive interventions. Training supervisors should also focus on leadership behaviors and how to establish positive relationships between supervisors and workers (38, 39), which was also part of one of the interventions evaluated in this thesis (i.e. ‘Mentorwijs’). Ample research, including studies in this thesis, show that positive and supportive relations play an important role in the employment and work participation of vulnerable workers (31, 40). Investment in leadership through training and strengthening relationships at work may especially be important for workers in vulnerable position, as they might have less job autonomy and other resources (38). Moreover, positive, and supportive relations also play an important role in the extent to which workers discuss their health-related problems with supervisors, and receive appropriate accommodations for that (31, 32). However, workers in a vulnerable position might not feel safe to disclose health-related problems, due to their more vulnerable position in the labor market (e.g. more often temporary or flexible contracts). Therefore, it is also important to train supervisors on how to ensure a work culture wherein workers feel safe to talk about health-related problems, which was also part of the ‘Mentorwijs’ training. 8
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