97 Monitoring the Dutch Solid Start program: developing an indicator set for municipalities Table 3. Selected indicators to monitor Solid Start on a local level (n = 19) Preconception Percentage of women and men in the reproductive age with debts Percentage of women and men in the reproductive age with psychological or psychiatric problems Percentage of women and men in the reproductive age with stress Percentage of women in the reproductive age who smoke Percentage of families reached with a preconception consultation (preconception care) Percentage of low literacy among young people (<30 years) without partner and children Percentage of women and men in the reproductive age living in a neighbourhood with a low liveability score Pregnancy Percentage of pregnant women with debts * Percentage of pregnant women who have their first antenatal care visit after the 10th week of pregnancy * Percentage of pregnant women with psychological or psychiatric problems Percentage of women who smoke at some point during pregnancy Percentage of pregnant women in a potentially vulnerable situation (3 or more risk factors to vulnerability) After birth (up to two years) Percentage of children born in a family with debts Percentage of families not receiving postpartum care (at home) after birth * Percentage of children aged 0 to 2 years of whom one or both parents have psychological or psychiatric problems Percentage of children born in a family in a potentially vulnerable situation (3 or more risk factors to vulnerability) * Percentage of children with a preterm birth or with a low birth weight for gestational age (SGA) * Percentage of children born in a family of which one or both parents have a mild intellectual disability Number of out-of-home placements for children before the age of 2 (per 1,000) * * These indicators are also included in the indicator set to monitor the national Solid Start program. DISCUSSION In this paper, we present an indicator set to monitor the Solid Start program in Dutch local coalitions, and we describe how we used a modified Delphi technique to reach consensus. The final indicator set consists of 19 indicators, covering the three phases of the Solid Start program: preconception (n = 7), pregnancy (n = 5) and after birth (up to two years) (n = 7). These indicators are available in nationwide data sources and can be presented on local (municipality) level. The indicator set meets the requirements as mentioned by the experts; it contains indicators that cover both processes and outcomes, both parents and children, and both risk- and protective factors. Additionally, the indicator set reflects both medical and social factors. A development agenda was established with topics and indicators that were prioritized, but lacked data in nationwide data sources or a clear operationalization. 4
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