Early-Life Policies and the Prevention of Multiple Long-Term Conditions: Findings From a Stakeholder Workshop Developed Collaboratively With Public Contributors

Abstract

Introduction

The multidisciplinary ecosystem to study life course determinants and prevention of early-onset burdensome multimorbidity (MELD-B) project examined early-life factors that contribute to the risk of developing multiple long-term conditions (MLTC) in adulthood. Insights from an initial stakeholder workshop shaped the project's direction and priorities. To continue this collaborative approach, we developed a second workshop with public contributors to reflect on how our research aligns with current early-life policies. We defined these as policies that support children and their families at an early stage to mitigate risk factors and strengthen protective factors for health and wellbeing across the life course, thereby reducing the risk of MLTC later in life. The workshop explored challenges facing children and young people within the system, considered practical applications of the research findings and identified priorities for future research.

Methods

The research team worked with three public contributors (one adult member of the MELD-B Advisory Group and two young researchers) to develop the workshop in terms of its questions, structure and format. Stakeholders were divided into three mixed-background groups, each facilitated by two team members, and discussions centred on predefined questions. Padlet (an online whiteboard) was used to collate ideas. Themes from the breakout rooms and full group discussions were initially identified with the aid of AI (Institutional account of Microsoft Copilot).

Results

Fifteen stakeholders from backgrounds including health visiting (n = 2), charities (n = 1), academics (n = 3), healthcare practitioners (n = 5) and council employees (n = 4), attended the workshop. Stakeholders emphasised that wider systems and environments shape child and family outcomes, with poverty and socioeconomic inequality acting as major upstream drivers. Stakeholders noted that gaps in data, fragmented information systems and poor linkage hinder informed decision-making, while short-term political and budget cycles, workforce pressures, insufficient funding and implementation challenges reduce the impact of early-years policies. Stakeholders agreed that the early years are the most critical period for effective action and require coordinated, cross-sector, whole-system approaches. Stakeholders highlighted the need for research to be translated into clear, actionable guidance, and stressed the importance of participatory engagement, clear communication and relational ways of working.

Conclusions

Our workshop identified key barriers to early-life policies as well as areas of best practice to guide future action.

Patient or Public Contribution

A public contributor who is a member of the MELD-B PPI Advisory Group and two young researchers from NxtGen, a young researcher training programme at the University of Southampton, were actively involved throughout the development and delivery of the workshop. They helped identify stakeholders to invite, developed the workshop agenda and contributed to the design of presentation materials. Their input shaped how key messages were communicated, helping to ensure that these were engaging, accessible and aligned with policies relevant to young people identified through previous NxtGen research. They also advised on the choice of interactive tools, with Padlet selected after testing alternative options. The public contributor attended the workshop, facilitated one of the breakout rooms and participated in discussions. All three contributed to the manuscript, including writing and editing the sections describing their involvement, providing reflective statements and designing the figure. All three are named co-authors.