Project overview
Liver disease is the second-biggest cause of early death in England and Wales. People from poorer communities are more likely to die from liver disease than people from richer communities. People with liver scarring (called cirrhosis) should have an ultrasound scan (like a pregnancy scan) twice a year to look for liver cancer. These scans are very important as they can pick up cancer early. A cancer that is picked up early is more likely to be cured and people with cancers picked up via regular scanning have almost half the chance of dying than those who present with symptoms from the cancer. Notably, people from poorer communities are less likely to have these scans than richer people. However, we know that support from other people in the community who also have liver disease can help people to attend liver health services. For this reason, we want to study whether other people with experience of liver disease can work as 'liver health champions' to help other people go to their scan appointments. For the Liver Health Champions care model to be tested properly we need to study it in communities that are likely to get the most help from it. Unfortunately, generally these communities and the services that support them do not do much research. In writing this application we have already met lots of people who work with these communities. But we need to do more. Therefore, the first thing we will do is build stronger relationships with service providers in five areas. The deprived coastal areas we will work in are Portsmouth, Southampton, the Isle of Wight, Hull and Newcastle. We will contact, meet and then mentor professionals in local hospitals and community services, e.g. drug and alcohol services and local authorities. The aim of these meetings will be to prepare them for running a study and work out what they need to make it happen. For example - they might need specific training on how to secure the research data we collect. The second group of people we will work with are members of the public and people they trust. We will reach them first by running five liver health roadshows. We have experience doing this but will work hard to make sure we meet people who wouldn't normally come forward for research or attend health appointments. We have already spoken with members of the public (our PPI group) for advice about this. One of their suggestions is that the events should take place close to food banks. People we meet at these events will then help us to plan follow up activity meetings. These might include arranging a hairdresser to cut people's hair. Our PPI group and experts have told us that activity meetings will be a good way to talk to people about the Liver Health Champion concept and about how they can work with us during the later study where we test it. Finally, we will bring members of the public (who we will call PPI contributors), professionals, and experts together. We will run two, one day events to co-design the study that will test the Liver Health Champions model. We will also use these meetings as an opportunity to share what we have learned, what we have achieved, and to give training to our PPI contributors, so they feel equipped to help us in the next study. This project will help to improve services for people with liver disease in poorer areas. Longer-term, the relationships we build will lead to more research in communities under-served by healthcare services.