Justice-centered best practices for accessibility to public buildings in a tier II city: Insights from a Delphi expert consensus.

Background: Despite beneficial progress in policies, awareness and advocacy, accessibility gaps exist in public buildings in India. Challenges achieving full inclusivity still exist, due to a lack of clear guidance for implementing accessible solutions. Retrofitting older buildings, particularly in developing tier II cities is a major challenge. The authors of this paper aimed to address this issue using a four-round Delphi method to generate a Justice-Centered Best Practices (JCBPs) for accessibility provisions for individuals with mobility disabilities. Methods: Conducted in Udupi, the study involved experts including administrators, policy implementers, auditors, advocates, healthcare professionals, individuals with disabilities and their caregivers. In the first round, a 117-item list was generated through triangulation of three methods. In subsequent rounds, experts rated each item using a 5-point Likert scale on feasibility, affordability and priority. Responses were considered valid if the agreement reached ≥80% on the total score. The prioritised list of JCBPs was finalised at a consensus meeting. Results: Out of forty-eight experts who began the study, 16 participated in the final meeting. The Wilcoxon signed rank test (p value>0.05) of expert ranking indicated that the scoring of items remained consistent between the two rounds. A machine learning decision tree analysis identified items securing ≥ 80% agreement as the most reliable decision with an accuracy=71.43%. The McNemar's Test p value=0.79 confirmed consistency of expert scoring on the items with high agreement rates. Conclusion: Finally, 33 built and non-built environment items scored highest rank. Stakeholder engagement, use of low-cost technology solutions, coordination between public administrations, funding, good governance practice, awareness, and advocacy were few of the solutions that can help ensure accessibility is in place for individuals with mobility disabilities. The study methodology and findings create a robust foundation for evidence-based JCBPs for accessibility provisions for individuals with mobility disabilities.