Background
Co-production is a collaborative approach to research that engages individuals who bring perspectives and skills from outside of the institutional/academic research enterprise to the research team. When patient partners (i.e., people with lived and living experience of a condition or disease) are engaged in co-production in health research it is referred to as patient engagement (PE) or patient and public involvement (PPI). This approach is intended to reduce research waste and generate more relevant and impactful results.

In health research co-production, patient partners are typically invited into existing research teams, where the academics on the team retain power and resources. This power imbalance may lead to tensions, tokenism, and a suboptimal experience for everyone on the team. If patient partners are used to validate knowledge they have played only a marginal role in producing, it may also reproduce and reinforce established biases. The PxP project demonstrates co-production where patient partners ‘held the power,’ and insitutionally-affiliated members of the team played a supportive role to ensure the project was successfully executed according to patient partners’ vision and decisions.

Methods
The Canadian Institutes of Health Research Institute of Musculoskeletal Health and Arthritis (CIHR-IMHA) has engaged patient partners for many years. CIHR-IMHA performs a research facilitation and leadership role and engages patient partners as members of its Patient Engagement Research Ambassadors initiative, supporting the group to set and realise its own priorities. In 2022,the Patient Engagement Research Ambassadors discussed hosting a conference, for and by patient partners, about patient engagement in research called PxP.

In early 2023, a PxP Steering Committee of international patient partners was formed. CIHR-IMHA provided organizational scaffolding to support all of the Steering Committee’s planning and decision making for the PxP conference, including personnel, financial, and operational resources.

Results and Discussion
The co-produced PxP Conference that patient partners led was a resounding success. We will share our experiences, successes, and challenges, and address concerns research teams may have when giving patient partners power and control over an initiative. The PxP Conference sessions, themes, and content were unique, tackling thorny and difficult topics. There was robust engagement on the virtual platform and overwhelmingly positive post-conference survey results. We will share adaptable aspects of the patient-centric conference design and explain how we are continuing momentum for the next PxP, building a like-minded community in the process. We will explore how the tradition of participatory design in Scandinavia offers a model for effective institutional allyship with marginalized communities. This model emphasizes the role of professional experts as amplifiers of lived, embodied and community expertise through providing sociomaterial infrastructure for community-led innovation.

Conclusion
The co-production in research space has few examples where patient partners are provided opportunities to lead initiatives. The PxP Conference showed that patient partners were able to completely design, execute, and continue to build on a successful initiative when given full control and resourced appropriately.