Patient and public involvement, engagement, and participation in practice: co-production of a creative health approach and theory of change through the ReCITE consortium-building project in Liverpool

Background
Co-production with public stakeholders is increasingly recognised as an important approach to ensuring health research is relevant to communities and interventions and likely to generate sustainable change. Ideally, co-production needs to be sustained throughout different stages of research and allow stakeholders ownership of the research agenda. We explore a case study of iterative co-production conducted over a nine-month period with a wide range of disparate stakeholders that transformed into a research-ready consortium able to design and obtain funding for a creative health research programme.

Main body
The ReCITE consortium is comprised of academics, creatives, and specialists in capacity development and community engagement in Liverpool, UK. Its main focus is health equity and coming up with new ways of working to tackle entrenched, avoidable and unfair differences in health. ReCITE led a series of six workshops in 2023 to co-produce a research programme to investigate creative approaches for improving health equity. Fifty-six stakeholders from the academic, creative and arts, health, community and voluntary sectors participated across six workshops that sought broad engagement and consolidated stakeholder input to develop a research agenda and expand the consortium. Common emerging themes were: (1) understanding complexities in funding creative health; (2) investigating storytelling as a catalyst for change; (3) achieving change through collective action; (4) the role of creative advocacy to change societal and funding structures; (5) evidencing the impact of community-led creative health interventions on health equity. These formed multiple co-produced outputs, including five pillars of a theory of change for the research that underpinned the research questions and determined five interventions to take forward by the research-ready consortium to securing funding for future work.

Conclusion
The iterative process of gaining stakeholder input, consolidating it, and seeking further input, helped to incorporate the perspectives of different stakeholder groups into different project outputs. Equitable power-sharing guided decision-making over what to prioritise was important in building ownership of the research agenda and trust among stakeholders. However, this was a lengthy iterative process and sustaining time commitment was difficult for those stakeholders who were not fully funded to participate.