The Midlands Liver Research Alliance - A partnership to optimise obesity-related liver disease research; targeting areas of high incidence and underserved communities.

Background

Non-alcoholic fatty liver disease (NAFLD) is defined as excessive triglyceride accumulation in the liver (hepatic steatosis). If hepatic lipid storage is sustained, metabolic dysfunction, inflammation, and advanced NAFLD can occur. NAFLD represents a spectrum of hepatic pathologies which augment cardiovascular and liver-related morbidity and mortality risk.

NAFLD prevalence is rapidly rising, driven by increasingly high levels of physical inactivity, obesity and type 2 diabetes. Overweight and obesity rates in the UK and disparity in NAFLD burden at population level is apparent, with incidence, prevalence and severity disproportionally affected by ethnicity, socioeconomic status and geographical location.

Aims

To establish a Midlands cross-sector, multi-disciplinary research partnership with national expert collaborators to address obesity-related liver disease and associated health inequalities. Optimise expert and stakeholder collaboration, resource utilisation and impact of existing NIHR infrastructure.

Objectives •Define obesity-related liver disease research priorities

•Cultivate a sustainable public and stakeholder engagement network focusing on hard-to-reach and underserved populations •Plan work to develop a core set of patient-reported outcomes •Create obesity-related liver disease satellite research sites in areas of need •Generate a research implementation framework

•Provide culturally appropriate training to NAFLD specialists •Offer training and mentoring to develop NAFLD research capacity Partnership activities 1) Patient and public involvement and engagement (PPIE) PPIE will have a central focus in this partnership, with multiple inclusivity and engagement activities to;

i) Develop NAFLD risk and awareness campaigns focusing on hard-to-reach and underserved communities

ii) Ensure programmes of work, research priorities and outputs are framed and co-designed by non-academic stakeholders and PPIE representatives iii) Provide researcher PPIE training and develop PPIE representatives for future co-applicant roles 2) Research strategy, priority setting and methodology

Stakeholder engagement meetings will inform the partnership’s research strategy and priorities. The establishment and development of priority research questions will be facilitated by our multi-disciplinary team of experts in NAFLD, obesity, pharmacotherapy, lifestyle medicine and trial methodology. Development of a plan to progress a Core Outcome Measures in Effectiveness Trial, COMET.

3) Partnership capacity and capability mapping

Partners via stakeholder engagement events will map existing infrastructure and expertise across the network, informing subsequent arrangements for training, mentorship and infrastructure development between partnership members and research sites. Delivery timeline 18 months Anticipated impact

The award will support the development of a Midlands-based multi-disciplinary research network in obesity-related liver disease. Through expertise and knowledge sharing across partners, we will establish a network of research centres of excellence, supported by emerging and established research leaders. Our bespoke partnership PPIE network will identify research priorities and obesity-related liver disease questions to inform high quality research.

We will support national work with areas of need, reducing health inequalities in access to research and embed research delivery best practice.