Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
J Occup Rehabil. 2022 Sep;32(3):438-451. doi: 10.1007/s10926-021-10010-x. Epub 2021 Nov 3.
Purpose Health problems among employees with a lower socioeconomic position (SEP) often result from an interplay of problems on multiple life domains. Contextual factors greatly affect implementation of interventions that aim to solve these type of problems. The aim of this study was to gain insight into the organizational and socio-political context for implementation of preventive interventions that consider multiple life domains among employees with a lower SEP. Methods In total 16 semi-structured interviews were conducted with stakeholders at organizational level, occupational health service (OHS) level, and at socio-political macro level. Thematic analysis was performed to identify themes that describe the perceptions of stakeholders about the impact of contextual factors on implementation. Results The following themes were identified: (1) the importance of addressing problems on multiple life domains among employees with a lower SEP, (2) unclarity of responsibilities for solving problems on multiple life domains, (3) necessity of better collaboration between occupational and curative healthcare, (4) insufficient investments in prevention by employers, (5) difficulties in early identification of employees at risk for health problems, and (6) risk of conflicting role for supervisors in addressing problems on multiple life domains. Conclusions Implementation of preventive interventions considering multiple life domains among lower SEP employees is challenging, due to various contextual factors. To improve the feasibility, many different stakeholders both in- and outside occupational health practice need to be involved, collaborate, and need to be convinced of the added value to prevent problems on multiple life domains among employees with a lower SEP.
目的 处于较低社会经济地位（SEP）的员工的健康问题通常是多个生活领域问题相互作用的结果。背景因素极大地影响旨在解决这些类型问题的干预措施的实施。本研究的目的是深入了解组织和社会政治背景，以实施考虑到处于较低 SEP 的员工的多个生活领域的预防干预措施。
方法 共对组织层面、职业健康服务（OHS）层面和社会政治宏观层面的利益相关者进行了 16 次半结构化访谈。采用主题分析方法识别描述利益相关者对背景因素对实施影响的看法的主题。
结果 确定了以下主题：（1）解决处于较低 SEP 的员工多个生活领域问题的重要性，（2）解决多个生活领域问题的责任不明确，（3）职业和治疗保健之间更好合作的必要性，（4）雇主对预防投资不足，（5）早期识别有健康问题风险的员工的困难，以及（6）主管在解决多个生活领域问题方面的角色冲突风险。
结论 由于各种背景因素，实施考虑到处于较低 SEP 的员工多个生活领域的预防干预措施具有挑战性。为了提高可行性，需要职业健康实践内外的许多不同利益相关者参与、合作，并确信预防处于较低 SEP 的员工多个生活领域问题的附加价值。
