260 Chapter 8 already apply and initiate different forms of integrated care (50). However, several studies show that the potential benefits of integrated care may not always be evident, as integrated care also involves complex processes and may lead to new challenges (e.g. lack of coordination) (51). As such, there is a great need for more research on the effectiveness of integrated care, and on how to facilitate and implement this effectively in practice. Grip on health intervention versus ‘Mentorwijs’ training In this thesis, both Grip on Health and ‘Mentorwijs’ aimed to improve the health and sustainable employability, but the approach on how to reach that goal was different. The Grip on Health intervention, which was implemented among workers with a lower SEP, aimed to solve problems on multiple life domains and reduce health risks. Whereas ‘Mentorwijs’, which was implemented among workers with a work disability, aimed to improve the guidance from supervisors to prevent early exit from the workforce. Although, these interventions may complement one another: First, ‘Mentorwijs’ can be implemented to address work-related problems with the help from supervisors. In addition, supervisors can also play a role in the early identification of workers at risk for health problems, as was also described in chapter 5. Herein they can refer a worker preventively to an OHP. ‘Grip on Health’ can in addition to ‘Mentorwijs’ be implemented to address both work- and non-work-related problems. Hence, to enhance the sustainable employment of workers in a vulnerable position ‘Mentorwijs’ focuses on selective prevention targeted at workers who have a higher-than-average risk to drop out of the labor market, and how supervisors can reduce this risk. Whereas ‘Grip on Health’ focuses on indicated prevention targeted at workers who have a high risk to drop out of the labor market (i.e. may already have health complaints), and how OHPs can reduce this risk. Grip on Health can be a successful method to support workers in a vulnerable position with solving problems on multiple life domains. However, the results of this thesis showed that the manner in which the Participatory Approach was implemented in Grip on Health does not work well in occupational health practice. In Grip on Health, the Participatory Approach was aligned with a broader perspective on health. However, by doing this the implementation of the intervention was perceived as complex by involved professionals because it resulted in solutions for different domains, asking (health) professionals from different domains to collaborate, which turned out to be difficult to organize. While the strength of the original Participatory Approach lays within small and practical solutions, that can easily be implemented as different stakeholders at the workplace reached consensus on solutions (52). Therefore, to adequately support workers in a vulnerable position with solving problems on multiple life domains occupational and curative health care should focus more on improving
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