Journal of Preventive Medicine and Public Health · 4 authors, 5 centres
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This hybrid study used a literature review, Delphi method with 20 experts, cross-sectional questionnaires, and artificial neural network analysis to identify and rank social determinants of health among informal settlement residents in a metropolitan area in Iran. Fifteen high-priority determinants were identified, including individual health literacy, nutrition, occupational factors, housing-related factors, and access to public resources.
This exploratory hybrid study was conducted in three phases from late 2019 to the end of 2020 in a metropolitan area in Iran. In the second phase, the Delphi method was applied with 20 experts over three rounds, ultimately identifying 96 SDHs, of which 43 were examined quantitatively using researcher-made questionnaires administered to informal settlement residents in a cross-sectional design. In the third phase, multilayer perceptron analysis using an artificial neural network ranked the SDHs by priority. Fifteen high-priority SDHs were identified, which together explained approximately 80% of the features of all variables. These included individual health literacy, nutrition, occupational factors, housing-related factors, and access to public resources. The findings suggest that interventions should focus on these high-priority determinants rather than solely on the most unfavorable conditions, and similar region-specific studies are recommended.
