258 Chapter 8 The results of this thesis indicated that training supervisors in the guidance of workers in a vulnerable position showed no significant effects on the long-term. The discussion of study designs in the methodological considerations showed that it was difficult in a difference-in-difference study design to differentiate effects of the intervention from unmeasured and/or unmeasurable factors. These factors may have played a role in the lack of significant effects, but lay outside the scope of ‘Mentorwijs’ and could not be adjusted for in the evaluation of the ‘Mentorwijs’ training. Therefore, more research is needed to examine the effectiveness of ‘Mentorwijs’ to determine how and under what conditions the intervention is effective. For instance, training supervisors is not enough, as supervisors should also have a supportive organizational environment to be able to provide the support that workers need. This implies that employers should develop and monitor organizational policies that make it possible for supervisors to adequately guide workers in a vulnerable position, including providing time and resources to supervisors that enable them to support workers in a vulnerable position. System at large According to the literature, there are three components to reflect on one’s sustainable employability: 1) work ability (i.e. physical, mental, and social wellbeing), 2) vitality (i.e. levels of energy and motivation) and 3) employability (i.e. ability to adequately perform various tasks and to function optimally at work now and in the future) (41). This thesis mainly focuses on the components work ability and vitality, and to a lesser extent on employability regarding their position in the labor market. Hence, the following recommendations mainly focus on how workers in a vulnerable position can remain sustainably employed in their current job and/or organization. Whereas for improving the health and sustainable employability of workers in a vulnerable position strengthening their position in the larger system of the labor market is also needed. A person-centered approach is required to support workers in a vulnerable position to remain healthy and sustainably employed. However, support from professionals is fragmented across different domains, and often focused on one life domain. This means that for a person-centered approach collaboration is needed with professionals from different domains. However, this thesis showed that collaboration is difficult, due to strict separation between occupational and curative health care. Therefore, we should explore possibilities of one institution or an external expert who can guide the process or is responsible for dealing with problems on multiple life domains. For families with problems on multiple life domains an external expert (i.e. wrap around care) is often used for the coordination of care (42). Workers in a vulnerable position may end up in a vicious cycle, and an external expert may help them to break out of this cycle and
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