172 CHAPTER 6 CONCLUDING REMARKS This thesis provided insight into the adoption of the Dutch nationwide action program Solid Start, with a specific focus to monitoring and cross-sectoral collaboration. Throughout our studies, we learned that monitoring vulnerability in early life and monitoring the action program Solid Start at local level requires a consideration of both risk and protective factors spanning across multiple sectors. This underscores the relevancy for preventive programs that connect the medical and social sector, and it implies that monitoring requires crosssectoral longitudinal data and indicators. Throughout the years, we found various incremental changes that supported collaboration across the medical and social sector to improve care and support during the first thousand days. Especially getting to know each other and processes of learning seemed to be indispensable in these processes towards cross-sectoral collaboration. In the wider adoption of the action program Solid Start, a unifying narrative, dedicated champions and a strong local focus appeared important facilitators. However, several challenges remain, and it is vital to learn from those to protect the health and well-being of current and future generations. Therefore, for future practice and policy, we advise to create a long-term perspective by positioning Solid Start as the ultimate form of prevention, and integrate the action program Solid Start into everyday practice, navigating in tandem with the IZA and GALA. Additionally, we recommend to stimulate learning processes within and across local, regional and national levels. These recommendations could help to further optimize the action program Solid Start, and contribute to the wider movement towards prevention and integration. Overall, this thesis implies a solid start for the Dutch first thousand days-approach.
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