89 Grip on Health intervention among lower socioeconomic position workers Introduction Workers with a lower socioeconomic position (SEP) have an increased risk for health problems and thereby premature dropout from the labor market (1-3). The Participatory Approach (PA) is a commonly applied intervention to prevent or reduce health risks at the workplace (4-6). The PA consists of a stepwise process to identify and solve problems at the workplace, through involvement of relevant stakeholders (7). Until now the PA has been implemented among workers in a wide variety of industries and workplace settings, but has not been specifically tailored to the needs of lower SEP workers. Research showed that the PA can positively impact physical and mental health outcomes (4, 5) and is therefore a promising method to prevent health problems among lower SEP workers. Whereas the PA solely focuses on problems at the workplace, problems outside the workplace also interfere with work functioning and health, and these problems are more prevalent among lower SEP workers (8, 9). This group of workers also has less problem-solving skills and is often confronted with an accumulation of problems (e.g. work-related problems, financial problems and/or unhealthy lifestyles), which makes it difficult for them to solve problems on their own (8, 9). Interventions that support lower SEP workers to solve problems on multiple life domains are therefore expected to be more effective (10). For that reason, the focus of the PA was extended to include a broader perspective on health to identify and solve problems on multiple life domains. This intervention is called ‘Grip on Health’. In addition, the original PA materials were considered too complex for lower SEP workers (11) and were also adapted to align with the skills of these workers. Process evaluations are used to understand the feasibility of the intervention, and to determine how, for whom and under what conditions the intervention is applicable in practice (12). Occupational health professionals (OHPs) deliver this intervention and many factors, such as competence and workload of OHPs, can influence implementation (13). Process evaluations can provide knowledge on whether the intervention was delivered as intended by OHPs, how they delivered the intervention in practice, and how they perceived its value to support lower SEP workers. In addition, a process evaluation can also provide more knowledge on whether the intervention has reached lower SEP workers as intended and fits this particular group of workers. More knowledge on the implementation of Grip on Health in practice, provides relevant insights on how OHPs could support lower SEP workers with solving problems on multiple life domains, in the context of Grip on Health and beyond. 4
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