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A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity

Sebastian Stannard Orcid Logo, Ann Berrington, Shantini Paranjothy, Rhiannon Owen Orcid Logo, Simon Fraser, Rebecca Hoyle, Michael Boniface, Becky Wilkinson, Ashley Akbari Orcid Logo, Sophia Batchelor, William Jones, Mark Ashworth, Jack Welch, Frances S Mair Orcid Logo, Nisreen A Alwan

Journal of Multimorbidity and Comorbidity, Volume: 13, Pages: 1 - 13

Swansea University Authors: Rhiannon Owen Orcid Logo, Ashley Akbari Orcid Logo

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DOI (Published version): 10.1177/26335565231193951

Abstract

Objective: Social, biological and environmental factors in early-life, defined as the period from preconception until age 18, play a role in shaping the risk of multiple long-term condition multimorbidity. However, there is a need to conceptualise these early-life factors, how they relate to each ot...

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Published in: Journal of Multimorbidity and Comorbidity
ISSN: 2633-5565 2633-5565
Published: SAGE Publications 2023
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However, there is a need to conceptualise these early-life factors, how they relate to each other, and provide conceptual framing for future research on aetiology and modelling prevention scenarios of multimorbidity. We develop a conceptual framework to characterise the population-level domains of early-life determinants of future multimorbidity. Method: This work was conducted as part of the Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) study. The conceptualisation of multimorbidity lifecourse determinant domains was shaped by a review of existing research evidence and policy, and co-produced with public involvement via two workshops. Results: Early-life risk factors incorporate personal, social, economic, behavioural and environmental factors, and the key domains discussed in research evidence, policy, and with public contributors included adverse childhood experiences, socioeconomics, the social and physical environment, and education. Policy recommendations more often focused on individual-level factors as opposed to the wider determinants of health discussed within the research evidence. Some domains highlighted through our co-production process with public contributors, such as religion and spirituality, health screening and check-ups, and diet, were not adequately considered within the research evidence or policy. 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spelling v2 64502 2023-09-11 A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity 0d30aa00eef6528f763a1e1589f703ec 0000-0001-5977-376X Rhiannon Owen Rhiannon Owen true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 2023-09-11 HDAT Objective: Social, biological and environmental factors in early-life, defined as the period from preconception until age 18, play a role in shaping the risk of multiple long-term condition multimorbidity. However, there is a need to conceptualise these early-life factors, how they relate to each other, and provide conceptual framing for future research on aetiology and modelling prevention scenarios of multimorbidity. We develop a conceptual framework to characterise the population-level domains of early-life determinants of future multimorbidity. Method: This work was conducted as part of the Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) study. The conceptualisation of multimorbidity lifecourse determinant domains was shaped by a review of existing research evidence and policy, and co-produced with public involvement via two workshops. Results: Early-life risk factors incorporate personal, social, economic, behavioural and environmental factors, and the key domains discussed in research evidence, policy, and with public contributors included adverse childhood experiences, socioeconomics, the social and physical environment, and education. Policy recommendations more often focused on individual-level factors as opposed to the wider determinants of health discussed within the research evidence. Some domains highlighted through our co-production process with public contributors, such as religion and spirituality, health screening and check-ups, and diet, were not adequately considered within the research evidence or policy. Conclusions: This co-produced conceptualisation can inform research directions using primary and secondary data to investigate the early-life characteristics of population groups at risk of future multimorbidity, as well as policy directions to target public health prevention scenarios of early-onset multimorbidity. Journal Article Journal of Multimorbidity and Comorbidity 13 1 13 SAGE Publications 2633-5565 2633-5565 Multimorbidity, Multiple Long-Term Conditions Multimorbidity, MLTC-M, lifecourse determinants, public health 31 12 2023 2023-12-31 10.1177/26335565231193951 http://dx.doi.org/10.1177/26335565231193951 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University This study/project is funded by the National Institute for Health Research (NIHR) under its Programme Artificial Intelligence for Multiple and Long-Term Conditions (NIHR203988). 2023-10-04T15:06:42.3837124 2023-09-11T11:40:24.7740533 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Sebastian Stannard 0000-0002-6139-1020 1 Ann Berrington 2 Shantini Paranjothy 3 Rhiannon Owen 0000-0001-5977-376X 4 Simon Fraser 5 Rebecca Hoyle 6 Michael Boniface 7 Becky Wilkinson 8 Ashley Akbari 0000-0003-0814-0801 9 Sophia Batchelor 10 William Jones 11 Mark Ashworth 12 Jack Welch 13 Frances S Mair 0000-0001-9780-1135 14 Nisreen A Alwan 15 64502__28704__5713661ea8d84afaad53736b885e6d5b.pdf 64502.VOR.pdf 2023-10-04T15:02:30.6480654 Output 1586713 application/pdf Version of Record true © The Author(s) 2023. Distributed under the terms of a Creative Commons Attribution 4.0 License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/
title A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
spellingShingle A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
Rhiannon Owen
Ashley Akbari
title_short A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
title_full A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
title_fullStr A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
title_full_unstemmed A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
title_sort A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
author_id_str_mv 0d30aa00eef6528f763a1e1589f703ec
aa1b025ec0243f708bb5eb0a93d6fb52
author_id_fullname_str_mv 0d30aa00eef6528f763a1e1589f703ec_***_Rhiannon Owen
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
author Rhiannon Owen
Ashley Akbari
author2 Sebastian Stannard
Ann Berrington
Shantini Paranjothy
Rhiannon Owen
Simon Fraser
Rebecca Hoyle
Michael Boniface
Becky Wilkinson
Ashley Akbari
Sophia Batchelor
William Jones
Mark Ashworth
Jack Welch
Frances S Mair
Nisreen A Alwan
format Journal article
container_title Journal of Multimorbidity and Comorbidity
container_volume 13
container_start_page 1
publishDate 2023
institution Swansea University
issn 2633-5565
2633-5565
doi_str_mv 10.1177/26335565231193951
publisher SAGE Publications
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.1177/26335565231193951
document_store_str 1
active_str 0
description Objective: Social, biological and environmental factors in early-life, defined as the period from preconception until age 18, play a role in shaping the risk of multiple long-term condition multimorbidity. However, there is a need to conceptualise these early-life factors, how they relate to each other, and provide conceptual framing for future research on aetiology and modelling prevention scenarios of multimorbidity. We develop a conceptual framework to characterise the population-level domains of early-life determinants of future multimorbidity. Method: This work was conducted as part of the Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) study. The conceptualisation of multimorbidity lifecourse determinant domains was shaped by a review of existing research evidence and policy, and co-produced with public involvement via two workshops. Results: Early-life risk factors incorporate personal, social, economic, behavioural and environmental factors, and the key domains discussed in research evidence, policy, and with public contributors included adverse childhood experiences, socioeconomics, the social and physical environment, and education. Policy recommendations more often focused on individual-level factors as opposed to the wider determinants of health discussed within the research evidence. Some domains highlighted through our co-production process with public contributors, such as religion and spirituality, health screening and check-ups, and diet, were not adequately considered within the research evidence or policy. Conclusions: This co-produced conceptualisation can inform research directions using primary and secondary data to investigate the early-life characteristics of population groups at risk of future multimorbidity, as well as policy directions to target public health prevention scenarios of early-onset multimorbidity.
published_date 2023-12-31T15:06:43Z
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