74 Chapter 3 intervention in occupational health practice. First, a process evaluation will be conducted, because this information is essential to determine how, for whom and under what conditions the intervention will be feasible and applicable. Thereafter, we will use this information to decide whether and how we should conduct an effect-evaluation in occupational health practice. A randomized controlled trial is an appropriate method for an effect-evaluation (61) if this is considered feasible within occupational health practice (62). Discussion This study describes how the PA was adapted to improve work functioning and health of workers with a low SEP from a broader perspective. Adaptation of the PA was guided by the IM protocol, which resulted in the Grip on Health intervention. In this intervention OHPs support workers with a low SEP in actively solving problems on multiple life domains that affect work functioning and thereby health. The intervention consists of a stepwise protocol to identify, prioritize, and solve problems in and/or outside the workplace with the involvement of at least one relevant stakeholder. The OHP is considered the optimal professional to execute this intervention in daily practice as he or she already has an independent and confidential role in occupational health care. Previous studies that used the IM protocol for the development of a PA intervention at the workplace focused on RTW (63, 64). These studies based their intervention on the Attitude Social influence Self-efficacy (ASE) model, as workers’ attitude, social influence and self-efficacy were identified as determinants for RTW. In this study the SDT was used as the needs assessment showed that workers with a low SEP may lack motivation to actively solve health problems, and according to this theory workers’ autonomy, competence and relatedness may increase their motivation for health-related behaviors (55). This is important as workers with a low SEP use avoidant and/or passive coping styles towards health problems, which could increase the risk of further health deterioration and eventually the chance for premature dropout from the labor market. The concepts of the SDT, which are autonomy, competence, and relatedness, are an essential part of the Grip on Health intervention and match well with the behavioral determinants self-efficacy and control that were described in the logic model of the problem. Moreover, participation of workers in the intervention could also increase the behavioral determinants awareness and risk perception towards health problems, which in turn may also improve the motivation of workers with a low SEP to solve these problems (65). Implementation of the PA with a broadened perspective is beneficial for occupational health practice, as there is still too little awareness that aspects in
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