Rosanne Schaap

92 Chapter 4 asked to deliver the intervention preventively, meaning that workers could already have problems on multiple life domains, but were not called in sick, or were on short-term sick leave (i.e. less than 6 weeks). Furthermore, lower SEP workers were all Dutch citizens, legally employed in a Dutch organization, with at least a permanent or fixed contract of more than 12 hours per week. OHPs delivered the intervention among lower SEP workers in case they noticed that workers had problems on multiple life domains that affected their work functioning or had a high degree of sickness absence. This means that lower SEP workers were recruited by OHPs as part of their normal way of working. Therefore, consent of the worker was not needed. OHPs only asked workers for consent to be approached by a researcher to schedule an interview. If a worker was willing to participate in an interview, then the worker signed informed consent before the start of an interview. Data collection The process evaluation among OHPs was conducted with mixed (quantitative and qualitative) methods during and after implementation of the intervention by means of: 1) questionnaires at the end of the training, which were completed by 35 OHPs, 2) checklists directly and 3 months after completion of the intervention, which were completed 27 times for workers who received the Grip on Health intervention, 3) semi structured group interviews during implementation with 13 OHPs who delivered and not (yet) delivered the intervention, 4) semi structured interviews after implementation, with 10 OHPs who delivered the intervention and three OHPs who did not implement the intervention, and 5) researcher logs during implementation of the intervention. The process evaluation among participants of the intervention was performed by conducting semi structured interviews with seven lower SEP workers who participated in all steps of the intervention. The checklists for OHPs and interview guides for OHPs and lower SEP workers can be found in additional file 1. The framework of the MRC was further operationalized by the use of the model of Linnan and Steckler (2002) and Carroll et al. (2007) (18, 19). Implementation was measured by reach, dose delivered and fidelity at OHP level, and quality of delivery at both OHP and participant level. Mechanisms of impact were measured by responsiveness and program differentiation, at OHP and participant level. Context was measured by investigating factors that affect implementation on the level of participants, intervention providers and the intervention itself (i.e. design and content of the intervention), and were part of the process evaluation components described above. This means that results of context are not displayed separately, but integrated in the process evaluation components. Contextual factors on organizational and socio-political level were described elsewhere (9). For further operationalization of the MRC framework see table 1.

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