272 Appendix Chapter 4 aimed to evaluate the Grip on Health intervention in a pilot implementation study. A mixed methods process evaluation was performed among OHPs and lower SEP workers with problems on multiple life domains. Thirteen OHPs delivered the intervention to 27 workers. According to OHPs and lower SEP workers, OHPs were perceived essential to help workers identify and solve problems. Moreover, OHPs and lower SEP workers described that the intervention increased workers’ health awareness and self-control and led to small and practical solutions. Grip on Health can be a successful method to support lower SEP workers with solving problems on multiple life domains. However, OHPs experienced several barriers on organizational level to implement the intervention in occupational health practice. Implementation was often affected by agreements on occupational health care between OHPs and employers or occupational health services and employers, and by difficulties with preventively reaching lower SEP workers with problems on multiple life domains. In chapter 5 a context analysis was conducted to further explore the impact of organizational and socio-political factors on the implementation of preventive interventions that aim to solve problems on multiple life domains among workers with a lower SEP. Semi-structured interviews were conducted with stakeholders at organizational level, occupational health service level, and at socio-political macro level. All stakeholders recognized the importance of addressing problems on multiple life domains among workers with a lower SEP. However, implementation of preventive interventions considering multiple life domains was perceived as challenging. No one feels fully responsible to solve all problems on multiple life domains, and there is a lack of collaboration between occupational and curative healthcare. Other barriers were that employers insufficiently invest in the prevention of health problems of their employees, and that it was difficult to identify workers at risk for health problems. Supervisors can play an important role in the early identification of workers at risk for health problems. However, supervisors discussing health-related problems may not always be desired, as they could take advantage of privacy sensitive information due to the unequal relationship between a supervisor and worker. These findings show that many different stakeholders both in- and outside occupational health practice need to be involved, collaborate, and need to be convinced of the added value to prevent problems on multiple life domains among workers with a lower SEP. Part III: The role of supervisors in supporting workers with a work disability In chapter 6 the experiences of workers with a work disability regarding the guidance from their supervisors were explored, together with what kind of aspects they consider important to achieve sustainable employability. Supervisors of workers with a disability followed a training to improve the guidance of workers
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