60 Chapter 3 adapt and self-manage physical, emotional, and social challenges of life could all be considered as health problems (20). In this approach health is more than the absence of disease, as one’s health status can be determined by multiple life domains. So, to improve work functioning and health of workers with a low SEP more effectively, the PA might extend its focus to identify and solve problems both in and outside the workplace. Therefore, the aim of this study is to adapt the PA to improve work functioning and health of workers with a low SEP from a broader perspective. Methods This paper describes the process of adaptation of the PA (Fig. 1), guided by the six steps of an Intervention Mapping (IM) protocol for development, implementation and evaluation of theory and evidence-based health promotion interventions (21). IM is not rigid, it is an iterative process which makes it possible to move back and forth between steps, and each step is based on previous steps. Moreover, IM stimulates involvement of stakeholders during the entire process to tailor interventions to the needs and wishes of these stakeholders. The Medical Ethics Review Committee of the VU University Medical Center approved the study protocol and confirmed that the Medical Research Involving Human Subjects Act does not apply to this study. All participants signed informed consent before participation. Step 1: Logic model of the problem • Establish and work with a planning group • Conduct a needs assessment to create a logic model of the problem Step 2: Program outcomes and objectives; logic model of change • State expected outcomes for behavior and environment • Specify performance objectives for behavior and environment • Construct matrices of change objectives • Create a logic model of change Step 3: Program design • Choose theory and evidence-based change methods • Select or design practical strategies to deliver change methods Step 4: Program production • Refine program structure and organization • Draft a protocol, training and materials • Pretest, refine and produce a protocol, training and materials Step 5: Program implementation plan • Identify potential program users • State outcomes, performance objectives and practical strategies for program users Step 6: Evaluation plan • Specify the evaluation design • Develop an evaluation plan with indicators and measures for assessment • Complete the evaluation plan Evaluation Implementation Figure 1. The six steps of Intervention Mapping adapted from Eldredge et al. 2016 (21)
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