Co-production of a stakeholder workshop to inform multimorbidity prevention research: working with public contributors to ask the right questions (the MELD-B experience)

Abstract

BackgroundThe MELD-B project aims to identify childhood lifecourse targets for the prevention of early-onset, burdensome multimorbidity, and to characterise ‘burden’ for people living with multimorbidity. Drawing upon lived experiences and the expertise of policy and practice stakeholders can enrich the MELD-B project, inform data analysis, and contribute to meaningful and practical outputs. In pursuit of this collaborative approach, a stakeholder workshop, co-produced with PPIE members, was conducted to inform the MELD-B project. MethodsFive PPIE members with lived experience of multimorbidity co-produced the planning of the workshop, including the utilisation of a project-specific animation and the creation of imaginary persona illustrating the lifecourse concepts of multiple long term conditions. 25 stakeholders with lived experience and policy and practice expertise of the early life course, from backgrounds including integrated care boards, healthcare practitioners, academics, council employees and not-for-profit organisations attended the 2 h workshop, and contributed in an advisory capacity. The workshop aimed to identify critical time points and targets in the early lifecourse (from before pregnancy up until 18 years), for feasible and practical interventions to prevent or delay multimorbidity. The stakeholders were split into three groups each facilitated by two team members and Jamboard (an online interactive whiteboard) was used to collate ideas. Overarching themes were then identified from these Jamboards. A poll was administered at the end of the workshop giving choices to prioritise time points for interventions. FindingsA number of focus areas emerged from the workshop that will inform future research on utilising longitudinal data for the early life course prevention of multimorbidity. Overarching themes included: mental health, educational attainment and attendance, the early identification of conditions and neurodiversity, diet and nutrition, and wider family factors. Stakeholders suggested that family-targeted interventions maybe more important to prioritise in early childhood, however at secondary school age individual-focused interventions may become more significant. The poll that included four timepoints (birth, 5, 10, and 16 years) identified -by an equal split- the first three as the most important timepoints for interventions, with ages 5 and 10 years considered transitional ages at the start of primary and secondary school respectively. Later adolescence (age 16 years) was not voted as a priority compared to the other timepoints. InterpretationCo-production with PPIE experts and stakeholders needs to become an integral early part of shaping research questions around prevention of multimorbidity. Our workshop has led to the identification of multiple priority themes and important timepoints from the perspective on those engaging with families and young people in their everyday work. This informs our next step in modelling prevention interventions using routinely collected and national cohort data. FundingThis work is part of the multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) project which is supported by the National Institute for Health Research (NIHR203988). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.