73 Participatory Approach to improve the health of low socioeconomic position workers also need to make their workers with a low SEP aware of this intervention by referring a worker to an OHP when they notice health problems or problems that affect work functioning. Performance objectives for these environmental agents to enable implementation are listed in Table 6. To achieve these performance objectives, the OHP needs to provide employers with information and make them aware of the added value of the Grip on Health intervention. Employers will receive information from the planning group about the intervention and the OHP is asked to discuss with the employer how and when the intervention can be implemented. Table 6. Performance objectives for employers 1. Employers are informed about the implementation of the Grip on Health intervention in their organization 2. Employers are convinced of the added value of the Grip on Health intervention in their organization 3. Employers approve that OHPs implement the Grip on Health intervention in their organization 4. Employers facilitate time and sufficient resources for OHPs to implement the Grip on Health intervention in their organization 5. Employers refer a worker to an OHP when they notice health problems or problems that affect work functioning. Step 6: evaluation plan To evaluate the pilot implementation of the Grip on Health intervention in occupational health practice we will use the Medical Research Council process evaluation framework (60). In this framework the key components of a process evaluation are: measuring implementation (i.e. what is implemented and how?), mechanism of impact (how does the delivered intervention produce change?) and context (i.e. how does context affect implementation and outcomes). Implementation of interventions at the workplace may be difficult as it is dependent on how occupational health care is organized in an organization and on a variety of stakeholders, such as employers and supervisors. This in turn, emphasizes the need for conducting a more comprehensive process evaluation of the Grip on Health intervention with different methods (i.e. both qualitative and quantitative) and from different levels (i.e. workers with a low SEP, OHPs and other relevant stakeholders). The process of the implementation will be assessed by measuring the following aspects: 1) reach, 2) recruitment, 3) fidelity, 4) dose delivered, 5) dose received and 6) quality of delivery. The mechanisms of impact will be assessed by measuring 1) participant responsiveness (i.e. perceived satisfaction, effectiveness, and relevance), and 2) perceived differentiation (i.e. essential components of the intervention). The context will be assessed by measuring the facilitators and barriers related to the implementation of the 3
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