68 Chapter 3 relatedness. In supplementary file 3, matrices of change objectives can be found for the behavioral outcome to identify what workers with a low SEP may need to learn or change to achieve the performance objectives. For the environmental agents the theoretical concepts competence and attitude were selected. For OHPs to support workers with a low SEP, it is important that they feel competent, create a safe environment, and have a positive attitude towards solving problems both in and outside the workplace. In supplementary file 4, matrices of change objectives can be found for the environmental outcome to identify what OHPs need to learn or change to achieve the performance objectives. Step 3: program design Theory and evidence-based change methods and practical strategies were formulated in Tables 3 and 4 for the selected determinants of the behavioral and environmental outcome. The already existing protocol of the PA was used as a starting point for the delivery of practical strategies. This PA protocol exists of different steps that are considered logical and provide a structured way of understanding what problems and solutions are considered most relevant (58). In applying the PA, a process leader is essential. OHPs are suitable for this role as they have communication skills, are independent, confidential and are used to guide workers with work-related problems. Furthermore, in the already existing protocol of the PA, the supervisor is often a relevant stakeholder for problems that are identified at the workplace (14). The worker and supervisor can together decide on the most important problems and solutions, which will give a higher chance of solutions being implemented at the workplace. If problems are identified outside the workplace relevant stakeholders can vary, for example spouse, family members, friends or (health) professionals (e.g. general practitioner or job coach from the municipality). They can provide another perspective on the most important problems and solutions or can provide support in the implementation of solutions outside the workplace. The PA protocol, training and material need to be adapted to fit the goal of discussing and solving health problems both in and outside the workplace that may affect work functioning, and are presented in step 4: program production.
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