183 Summary longitudinal monitoring and policy making. Nevertheless, results also showed that selfreported data was of added value in the predictions, and self-reported health variables were found to be important predictors to multidimensional vulnerability. In Chapter 4, we described the development of an indicator set to monitor the action program Solid Start on a local level. Experts preferred an indicator set that covers both processes and outcomes, both parents and children, and both risk and protective factors. The final indicator set comprised nineteen indicators within the three phases of the Solid Start program: preconception, pregnancy and after birth. Topics included poverty, psychological/psychiatric problems, stress, smoking, vulnerability, preconception care, low literacy and premature birth. The indicators focused on social determinants of health rather than specific clinical aspects. Additionally, a development agenda was set with topics and indicators that lacked nationwide data or clear operationalization (e.g. stress, unintended pregnancy, loneliness). In the local monitoring of the action program Solid Start, the indicator set can enhance the conversation between policymakers, managers, professionals and other stakeholders about the local situation and developments to prioritize local interventions and policies. Chapter 5 described the developments and experiences with the action program Solid Start, with a specific focus on cross-sectoral collaboration. This study took place during the program’s own first thousand days (i.e. 2019, 2020 and 2021). Quantitative results showed an increasing number of local coalitions Solid Start that involved diverse stakeholders from the medical and social sector, and a growing number of municipalities with plans of action, objectives, ambitions and activities. Qualitative results showed various positive experiences, but also challenges and needs for improvement. Initiating the action program Solid Start increased the sense of urgency for the importance of the first thousand days and stimulated professionals to get to know each other, resulting in more collaborative agreements. Coalition-development varied due to municipalities’ unique challenges, focus and historical contexts. Some facilitators for local coalitions Solid Start were an active coordinator as driving force and a shared societal goal. Moreover, stakeholders appreciated the program’s strong local focus and opportunities for learning together. However, the action program Solid Start appeared not yet fully incorporated into all professionals’ everyday practice. Most common barriers related to systemic integration at macro-level, including limited resources and collaboration-inhibiting regulations. Stakeholders suggested various needs to ensure the program’s sustainability, including sustainable funding, supportive regulations, responsiveness to stakeholders’ needs, ongoing knowledge development and learning, and better and more client involvement. Chapter 6 outlines a general discussion with main findings, a reflection on these findings, methodological considerations and recommendations for research, policy, practice and education. We highlight six lessons learned into the adoption of the action program Solid Start (lesson 1 & 2), monitoring (3 & 4) and cross-sectoral collaboration (5 & 6):
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