Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, Amsterdam, The Netherlands.
HAN University of Applied Sciences, Laan van Scheut 10, 6525 EM, Nijmegen, The Netherlands.
BMC Health Serv Res. 2022 Nov 30;22(1):1459. doi: 10.1186/s12913-022-08801-w.
For working patients with a lower socioeconomic position, health complaints often result from a combination of problems on multiple life domains. To prevent long-term health complaints and absence from work, it is crucial for general and occupational health professionals to adopt a broad perspective on health and to collaborate when necessary. This study aimed to evaluate how the 'Grip on Health' intervention is implemented in general and occupational health practice to address multi-domain problems and to promote interprofessional collaboration.
A process evaluation was performed among 28 general and occupational health professionals, who were trained and implemented the Grip on Health intervention during a six-month period. The 'Measurement Instrument for Determinants of Innovations' was used to evaluate facilitators and barriers for implementing Grip on Health. Data included three group interviews with 17 professionals, a questionnaire and five individual interviews.
While most health professionals were enthusiastic about the Grip on Health intervention, its implementation was hindered by contextual factors. Barriers in the socio-political context consisted of legal rules and regulations around sickness and disability, professional protocols for interprofessional collaboration, and the Covid-19 pandemic. On the organizational level, lack of consultation time was the main barrier. Facilitators were found on the level of the intervention and the health professional. For instance, professionals described how the intervention supports addressing multi-domain problems and has created awareness of work in each other's healthcare domain. They recognized the relevance of the intervention for a broad target group and experienced benefits of its use. The intervention period was, nevertheless, too short to determine the outcomes of Grip on Health.
The Grip on Health intervention can be used to address problems on multiple life domains and to stimulate interprofessional collaboration. Visualizing multi-domain problems appeared especially helpful to guide patients with a lower socioeconomic position, and a joint training of general and occupational health professionals promoted their mutual awareness and familiarity. For a wider implementation, stakeholders on all levels, including the government and professional associations, should reflect on ways to address contextual barriers to promote a broad perspective on health as well as on collaborative work.
对于社会经济地位较低的在职患者，健康问题通常是多个生活领域问题共同作用的结果。为了预防长期的健康问题和缺勤，全科和职业健康专业人员必须采用广泛的健康视角，并在必要时进行协作。本研究旨在评估“健康抓手”干预措施在全科和职业健康实践中是如何实施的，以解决多领域问题并促进跨专业合作。
对 28 名接受过培训并在六个月内实施“健康抓手”干预措施的全科和职业健康专业人员进行了过程评估。使用“创新决定因素测量工具”评估实施“健康抓手”的促进因素和障碍。数据包括与 17 名专业人员进行的三次小组访谈、一份问卷和五次个人访谈。
尽管大多数卫生专业人员对“健康抓手”干预措施充满热情，但由于环境因素，其实施受到阻碍。社会政治环境中的障碍包括与疾病和残疾相关的法律规则和法规、跨专业合作的专业协议以及新冠疫情。在组织层面，缺乏咨询时间是主要障碍。在干预措施和卫生专业人员层面发现了促进因素。例如，专业人员描述了该干预措施如何支持解决多领域问题，并提高了对彼此医疗保健领域工作的认识。他们认识到该干预措施对广泛的目标群体具有相关性，并体验到了其使用的益处。然而，干预期太短，无法确定“健康抓手”的效果。
“健康抓手”干预措施可用于解决多个生活领域的问题，并促进跨专业合作。可视化多领域问题对于指导社会经济地位较低的患者尤其有帮助，而对全科和职业健康专业人员进行联合培训则促进了他们之间的相互了解和熟悉。为了更广泛的实施，各级利益相关者，包括政府和专业协会，应思考如何解决环境障碍，以促进广泛的健康视角和协作工作。
