75 Participatory Approach to improve the health of low socioeconomic position workers multiple life domains may influence work functioning and it is therefore essential to take these into account to prevent work disability. This broadened perspective is also more in line with the Positive Health approach. In this approach, first a person evaluates each health domain for him or her selves, wherein the health status on each of these domains becomes visible. Then, a health professional asks the person what he or she wants to change to provide guidance in solving those problems that are really important to the person (24). In that way, the Positive Health approach focuses on a person’s own responsibility, participation, and self-management, which is also apparent in their definition of health: “Health as the ability to adapt and self-manage, in the light of physical, emotional and social challenges of life” (20). However, one of the main points of criticism of the Positive Health approach is that not all people are equipped to manage problems themselves, especially people with a low SEP. For individuals with problems on multiple life domains an intervention wherein (health) professionals, social networks and organizations are involved is necessary to improve their health status (25). The Grip on Health intervention tackles this point of criticism, as in the PA the OHP not only asks the worker what problems he or she wants to change but also involves relevant stakeholders and supports the worker in solving these problems. Methodological considerations IM was a valuable tool to adapt the PA to the needs of the target group, workers with a low SEP. However, this is not a guarantee that the intervention will be successful. There are still some methodological considerations of the intervention itself. First, workers with a low SEP may be hard to reach for OHPs. The needs assessment showed that OHPs have a lack of trust and familiarity among workers with a low SEP. Therefore, OHPs are not easily approached or accessible as a health professional who can support them in solving health problems both in and outside the workplace. Furthermore, workers visit primarily a general practitioner when they are experiencing health problems outside the workplace. Integrating occupational and general health care might be a strategy to reach more workers in occupational health care (66). For example, general practitioners could take into account work-related problems, be more aware of the importance of work as a contributory factor of health and if needed refer a worker to an OHP. Second, it may also be challenging to involve relevant stakeholders from outside the workplace in an intervention that is facilitated and financed by the workplace. Stakeholders from outside the workplace could be the partner or family member of the worker, but also another health professional. However, including other health professionals for a face-to-face discussion with the worker and the OHP may be too difficult to organize in practice, but will depend per situation. For example, in the Netherlands occupational health care is strictly separated from 3
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