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Background: 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., Method: 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., Results: 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., Conclusion: 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., (© 2022. The Author(s).)

Background: To this date, there is little to no interprofessional collaboration between professionals in general and occupational health care in the Netherlands. Where earlier initiatives for improvement focused on general practitioners (GPs) and occupational physicians (OPs), we examine the role that professionals working under task delegation of GPs and OPs can play in addressing problems on multiple life domains as well as in interprofessional collaboration. Methods: We conducted three focus group interviews with 7 assistant practitioners (APs) in general practice, 11 practice nurses (PNs) in general practice and 8 APs in occupational health practice. Results: All PNs and APs in our study are confronted with multi-domain problems and see a role for themselves in addressing these problems. Moreover, in case of multi-domain problems, they acknowledge the relevance of interprofessional collaboration to provide good care. At this moment, however, there is practically no collaboration at the level of PNs and APs. Challenges are found in the formal task delegation and role identity of the APs in occupational health practice, unfamiliarity and prejudices among especially general practice PNs and APs regarding occupational health care, and practical barriers as privacy laws and reachability. Conclusion: Interprofessional collaboration among PNs and APs in general and occupational health care is possible, provided that a solution is found for fundamental and practical challenges. Potential solutions are to shift the focus from sharing medical information to communicating about the needs of working patients to function healthily on multiple life domains, to address interprofessional collaboration in educations, to adapt consultation protocols to include work and to organize joint meetings between professionals in general and occupational health practice. Finally, addressing structural barriers such as privacy laws and financing requires political action., (© The Author(s) 2022.)

Background: Many work-related items are not included in the current classification of environmental factors from the International Classification of Functioning, Disability and Health (ICF). Furthermore, personal factors are not classified and the ICF only provides a very limited list of examples. These facts make the ICF less useful for occupational health care and for research in the field of occupation and health., Objective: The objective of this discussion paper is to introduce an elaboration of contextual factors, focussing on factors that influence work participation., Methods: During the last 12 years, we developed two concept lists from the bottom up. These lists are based on our experiences in teaching and research, suggestions from students and other researchers, and factors found in the literature. In the fall of 2015 a scoping literature review was done to check for missing factors in these two concept lists., Results: An elaboration of contextual factors, consisting of a list of work-related environmental factors and a list of personal factors., Conclusions: Important contextual factors that influence work participation are identified. Researchers, teachers, students, occupational and insurance physicians, allied health care professionals, employers, employees, and policy makers are invited to use the elaboration and to make suggestions for improvement. The elaboration and the suggestions received can be used in the ICF revision process. The development of an ICF ontology must be given priority, to give room to this elaboration, which will increase the applicability of the ICF and enable mapping with other terminologies and classifications.