165 General discussion on quantitative indicators and stakeholder experiences, enabling the Ministry to provide a rationale for her activities and shape future policy developments (e.g. as input for a followup approach). Our evolving role implies the adoption of more flexible and collaborative approaches oriented at learning for policy and practice, and involves using a wide variety of qualitative and quantitative methods, and engaging more experts-by-experience. This was most evident in the setup of the learning local monitor Solid Start, which comprised small scale-learning sessions, larger-scale theme sessions and the development of a local indicator set. Responding to participant’s needs, we consequently developed a dashboard displaying municipality-level data for these local indicators, available at www.regiobeeld. nl/kansrijkestart, to stimulate local conversations and decision-making. This tool is still in development, with requests to expand its capabilities (e.g. adding neighbourhood- and regional data) and add indicators from the developmental agenda (e.g. stress, unintended pregnancy, loneliness). We believe that involving the experts that will use the indicators from the start of development was beneficial to increase acceptance and utilization, just like previous research described how involving care providers is crucial for transformational change (64). Additionally, our research on the operationalization of vulnerability was notably driven by local and national demands for a better understanding on the prevalence, geographical distributions and trends in vulnerability. As a result of the broadened monitoring scope, we have produced a diverse array of products relevant for policy (factsheets), research (scientific papers) and practice (indicator set, websites, meetings). The shift away from conducting research in isolation, particularly in the context of complex and cross-sectoral programs, is increasingly apparent in other monitors and projects as well. Examples include the reflexive evaluation of the program ‘Right Care at the Right Place’ (65, 66) and the monitor of the ‘Healthy and Active Living Agreement’ (67). Moreover, there is growing adoption of participatory research designs, characterized by collaborations between researchers and local stakeholders to create and apply relevant knowledge for societal issues in practice, to evaluate and facilitate integration across the medical and social sector (e.g. 68). Engaging with knowledge users throughout all research phases can significantly enhance the uptake of research in practice or policy, facilitating a transition from scientist-driven to problem-based research (69-71). Beckett and colleagues (72) call to embrace the inherent complexity and uncertainty of ‘research co-production’ and not just focus on the end-goal of changing practice, emphasizing that more nuanced effects on knowledge sharing, relationships and research capacity building can be expected. Hence, we recommend applying more participatory and co-productive forms of research to advance the Solid Start movement. By doing so, we can address questions that align with the needs and priorities of stakeholders in practice, enhance collaborative learning and better support the processes towards integration. In this regard, the National Institute for Public Health and the Environment can further evolve to a learning organization, actively engaging in iterative processes with stakeholders. Embracing participatory and co-productive research approaches also necessitates different competencies (20) and more flexibility. It implies that the authority for decision-making, including goal-setting and methodologies, is no longer exclusively entrusted to those in the academic world (as 6
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