A novel framework for operationalising patient and public involvement: lessons from designing an AI-informed exercise prescription grant

BACKGROUND: While grant funders such as the National Institute of Health and Care Research increasingly require patient and public involvement (PPI) across all stages of grant development, there remains limited documentation on how meaningful PPI involvement is operationalised, and how its impact is measured. This aim of this case study was to describe how PPI can be embedded in a research grant application to develop an Artificial Intelligence-informed exercise programme for individuals living with chronic illness. METHODS: We constructed a four-stage framework to operationalise the process of integrating PPI across the grant development process, including: gathering initial PPI feedback, establishing a lived experience advisory panel (LEAP), co-developing the grant submission, and conducting an impact assessment guided by the 2019 UK Standards for Public Involvement, GRIPP2 reporting checklist, and prior PPI expertise. RESULTS: Our framework for incorporating PPI across the grant development process was found to be impactful across all measures of the UK Standards for Public Involvement. Following stage 1, we implemented a sequential process for forming a lived experience advisory panel (stage 2) and demonstrated a robust, approach to document the impact of PPI on grant development (stage 4). Important themes that developed from the group feedback during stage 1 and 2 included concerns over trust and consistency of physical activity recommendations, empowerment through active engagement, meeting user needs, appropriateness of data collection methods, digital literacy and widening recruitment opportunities which influenced the grant design. Significant learnings from stage 3 and 4 for future PPI highlight the importance of considering wider contextual factors which influence the impact of PPI on grant development. Factors such as engaging with local community groups serving under-represented patient cohorts to increase the diversity of PPI participants, and consideration of PPI activity accessibility for those with chronic health conditions. CONCLUSIONS: This paper provides a novel framework which can be used by researchers to plan and carry out meaningful PPI in their grant applications. Embedding PPI across the grant development process resulted in meaningful contributions that shaped the proposal and will continue to influence the project's trajectory. This paper recommends employing a clear methodology for involving PPI and capturing its impact from the outset to enhance the relevance, transparency, and inclusivity of research. This case study highlights the value of sustained and structured PPI in co-producing impactful health research and grant activities.