Determinants of seat belt use among drivers in Sabzevar, Iran: a comparison of theory of planned behavior and health belief model

Predicting risky driving behaviours using the theory of planned behaviour: A meta-analysis

The current meta-analysis explored the efficacy of the theory of planned behaviour (TPB) in predicting high-risk driving behaviours. Specifically, we examined speeding (in relation to exceeding the limit as well as speed compliance), driving under the influence, distracted driving, and seat belt use. We searched four electronic databases (i.e., PubMed, Web of Science, Scopus, and ProQuest) and included original studies that quantitatively measured the relationships between the TPB variables (attitude, subjective norm, perceived behavioural control [PBC], intention, and prospective/objective behaviour). The study identified 80 records with 94 independent samples. Studies were assessed for risk of bias using the JBI checklist for cross-sectional studies and compliance with the TPB guidelines. Together, attitude, subjective norm and PBC explained between 30 % and 51 % of variance found in intention, with attitude showing as the strongest predictor for intention across the different driving behaviours. The findings also showed that the model explained 36 %-48 % variance found in predicting the observed and/or prospective behaviours for distracted driving, speed compliance and speeding. Understanding the varying strengths and thus relative importance of TPB constructs in predicting different risky driving behaviours is crucial for developing targeted road safety interventions.

Predictors of older people's intention to engage in cycling violation behaviour with an integrative model

In China, bicycles are a popular mode of transportation for senior citizens. A disproportionate number of traffic-related fatalities and injuries involve cyclists. The violation of cycling laws is a significant cause of cyclist crashes. Few studies have analyzed the cycling violation behaviour of seniors. Therefore, it is essential to examine the factors that influence older individuals' intention to engage in cycling violation behaviours. In this study, the effects of social-demographic characteristics, the exogenous constructs in the health belief model (HBM), and the theory of planned behaviour (TPB) on senior cyclists' violation intention were investigated using hierarchical regression analysis. Interviews were conducted with older cyclists in urban areas of Wuhan City, all above 60 years of age. The results showed that very little variance in behavioural intention could be explained by social-demographic factors. The TPB has a significantly greater capacity than the HBM to explain variance in behavioural intention. Perceived susceptibility, perceived benefit, cues to action, subjective norm and attitude significantly impacted behavioural intention, whereas perceived severity, perceived barrier and self-efficacy did not.

Predictors of parents' use of child restraint systems: Evidence from China

OBJECTIVE

Child restraint systems (CRS) can significantly lower the chance of child harm and death. Despite the benefit of CRS, their use in developing countries is low. Therefore, examining the factors that affect parents' use of CRS is essential.

METHODS

In this study, the associations of demographic characteristics and the exogenous constructs in the health belief model (HBM) and the theory of planned behavior (TPB) with parents' CRS use were investigated with structural equation modeling.

RESULTS

Demographic factors alone explained 23.1% of the variance in CRS use. The model's explanatory power increased greatly when exogenous constructs were incorporated from the HBM and TPB. Having a college degree, knowledge about CRS, perceived susceptibility, self-efficacy, and attitude significantly impacted parents' use of CRS.

CONCLUSIONS

The use of CRS in China is still low. Much effort should be done to increase the use of CRS in China, including education, and publicity.

Prediction of Seat Belt Use Behavior among Adolescents Based on the Theory of Planned Behavior

BACKGROUND

Road Traffic Injuries (RTIs) are the important causes of unintentional injuries and deaths. In this respect, seat belt wearing is an influential factor in reducing the mortality and severity of road traffic injuries. The rate of seat belt use among is lower adolescents, compared to adults. The present study aimed to investigate the influential factors on seat belt-weraing behavior among adolescent students as car occupants based on the Theory of Planned Behavior (TPB).

STUDY DESIGN

  A cross-sectional design.

METHODS

This study was conducted among 952 adolescent students studying in grades 7, 8, and 9 in the schools of Tabriz, Iran, in the 2019-20 academic year. A researcher-made questionnaire was designed based on TPB for data collection, the validity and reliability of which have been confirmed.

RESULTS

The results indicated that the rate of seat belt use in the front seat inside the city was lower than that outside the city. Regarding TPB constructs, perceived behavioral control (β=0.137; 95% CI: 0.006-0.013; P<0.001), subjective norm (β=0.313; 95% CI: 0.021-0.032; P<0.001), and attitude (β=0.322; 95% CI: 0.034-0.053; P<0.001) had a significant and positive relationship with the intention of seat belt-wearing behavior. Moreover, the behavioral intention (β=0.571; 95% CI: 0.62-0.64; P<0.001) had a significantly positive relationship with seat belt-wearing behavior.

CONCLUSION

The Theory of Planned Behavior is appropriate to determine predictor factors of seat belt-weraing behavior among adolescent students as car occupants. In addition, the results of the present study may provide a theoretical basis for policy-making to improve adolescent students' seat belt use.

Predictors of Seat-Belt Use among Bus Passengers in Ghana: An Application of the Theory of Planned Behaviour and Health Belief Model

BACKGROUND

Seat-belt use is effective in preventing traffic fatalities and injuries yet its use is not universal. This study sought to determine the predictors of self-reported seat-belt use among bus passengers in Ghana based on the theory of planned behaviour and health belief model.

METHODS

A quantitative cross-sectional study design with 633 randomly selected intercity bus passengers was conducted using a structured questionnaire in Kumasi, Ghana. The resulting data were analysed using SPSS version 23.0. Ordinal regression was employed to determine the predictors of self-reported seat-belt use.

RESULTS

Majority of the respondents were male (61.5%) with a mean age of 32.2 (SD = 11.6). A third (33.0%) reported that they always wear their seat-belt as bus passengers. The results indicated that intention (OR = 1.49, 95% CI = 1.21-1.84, p = 0.001), subjective norm (OR = 1.57, 95% CI = 1.15-2.13, p = 0.004) and perceived behavioural control (OR = 1.53; 95% CI = 1.21-1.92, p = 0.001) variables from the theory of planned behaviour were significant independent predictors of seat-belt use. Among the health belief model variables, perceived severity (OR = 1.57, 95% CI = 1.15-2.16, p = 0.005) and perceived barriers (OR = 0.52, 95% CI = 0.39-0.67, p = 0.001) were the only significant independent predictors of self-reported seat-belt use.

CONCLUSION

The findings suggest that intention, subjective norm, perceived behavioural control, perceived severity and perceived barriers play an important role in determining bus passengers' seat-belt use behaviour. Road safety programmes to increase seat-belt use will gain from giving serious attention to these factors in the design and implementation of such programmes.

Factors affecting pedestrian behaviors at signalized crosswalks: An empirical study

INTRODUCTION

Safety of pedestrians depends, among other factors, on their behavior while crossing the road. This study aims to assess behaviors of pedestrians at signalized crosswalks.

METHOD

Following a literature review and a pilot study, 25 vital pedestrian crossing factors and behaviors were determined. Then data was randomly collected for 708 pedestrians at 10 lighted crossings in Sharjah (UAE), five at road intersections and five mid-block crossings.

RESULTS

Results indicated that 17.4% of pedestrians observed crossed partly or fully on red and that crossing speed was 1.22 m/s, on the average, which is slightly faster than most speeds recorded in the literature. Moreover, female pedestrians were more likely to cross while chatting with others, less likely to cross on red, and more likely to walk slower than male pedestrians. Results also showed that pedestrians who crossed at road intersections walked slower than those who crossed at mid-block crossings. It was also found that longer red pedestrian times and narrower roads tended to encourage pedestrians to cross on red and that the majority of pedestrians did not look around before crossing.

PRACTICAL IMPLICATIONS

Use of the Health Belief Model for pedestrian safety are discussed.

Getting Young Drivers to Buckle Up: Exploring the Factors Influencing Seat Belt Use by Young Drivers in Malaysia

Many car drivers in Malaysia, especially young drivers, ignore the importance of wearing seat belts. This questionnaire study employed an extended version of the theory of planned behaviour (TPB) by including habit as a new construct to explain the factors influencing the behavioural intention and expectation of young Malaysian drivers to use seat belts. A total of 398 young drivers from the state of Selangor in Malaysia participated in this study. Analyses used a covariance-based structural equation modelling (CB-SEM) approach. The results showed that the variance, which indicates the intention of young Malaysian drivers to use seat belts (R2 = 0.76), is influenced by drivers’ habits and three basic constructs of the TPB (attitude, subjective norms, and perceived behavioural control). The basic TPB constructs have a direct and positive impact on the intention of young Malaysian drivers to use seat belts. Drivers’ habits have a positive and direct influence on their intention to use seat belts, and an indirect influence via the attitude and perceived behaviour control constructs. Drivers’ habits do not influence subjective norms. The authors recommend implementing effective measures to encourage Malaysian drivers to use seat belts and ensure sustainable traffic safety.

A Comparison of Motorcycle Helmet Wearing Intention and Behavior between Urban and Rural Areas

The motorcycle is one of the important modes of transport for Thai people in all provinces due to its convenience and ability to access all areas and cover short distances, which is especially convenient for rural people. However, according to the accident record, it was found that the motorcycle was the vehicle causing the highest amount of accidents, and helmet wearing could save lives and reduce the level of severe injuries. In this regard, the objective of this study was to study and develop a model of factors that affected helmet use behavior using structural equation modeling (SEM) based on the Health Belief Model (HBM). Further, this study compared urban and rural models, so as to suggest suitable guidelines for the promotion of helmet use in the study areas. The sample comprised 801 motorcycle users divided into 401 urban residents and 400 rural residents. From the parameter invariance testing in the two areas, a chi-square difference test found differences in the factor loading, intercepts, and structural paths between urban and rural societies.

A home-based approach to understanding seatbelt use in single-occupant vehicles in Tennessee: Application of a latent class binary logit model

Although the enforcement of seatbelt use is considered to be an effective strategy in reducing road injuries and fatalities, lack of seatbelt use still accounts for a substantial proportion of fatal crashes in Tennessee, United States. This problem has raised the need to better understand factors influencing seatbelt use. These factors may arise from spatial/temporal characteristics of a driving location, type of vehicle, demographic and socioeconomic attributes of the vehicle occupants, driver behaviours, attitudes, and social norms. However, the above factors may not have the same effects on seatbelt use across different individuals. In addition, the behavioural factors are usually difficult to measure and may not always be readily available. Meanwhile, residential locations of vehicle occupants have been shown to be associated with their behavioural patterns and thus may serve as a proxy for behavioural factors. However, the suitability of geographic and residential locations of vehicle occupants to understand the seatbelt use behaviour is not known to date. This study aims to fill the above gaps by incorporating the residential location characteristics of vehicle occupants in addition to their demographics and crash characteristics into their seatbelt use while accounting for the varying effects of these factors on individual seatbelt use choices. To achieve this goal, empirical data are collected for vehicular crashes in Tennessee, United States, and the home addresses of vehicle occupants at the time of the crash are geocoded and linked with the census tract information. The resulting data is then used as explanatory variables in a latent class binary logit model to investigate the determinants of vehicle occupants' seatbelt use at the time of the crash. The latent class specification is employed to capture the unobserved heterogeneity in data. Results show that Tennessean drivers belong to two general categories-conformist and eccentric-with gender, vehicle type, and income per capita determining the likelihood of these categories. Overall, male drivers, younger drivers, and drivers who have consumed drugs are less likely to wear a seatbelt, whereas drivers who come from areas with higher population density, travel time, and income per capita are more likely to wear a seatbelt. In addition, driving during the day and in rainy weather are associated with an increased likelihood of seatbelt use. The findings of this study will help developing effective policies to increase seatbelt use rate and improve safety.

Safe driving behaviors among taxi drivers: a predictive cross-sectional study based on the health belief model

Background

The purpose of this study was to predict safe driving behaviors among taxi drivers of Tehran based on the constructs of health belief model.

Methods

This descriptive-analytical study was performed on 450 taxi drivers in Tehran using multi-stage sampling. Data were analyzed through SPSS software version 18 using Pearson correlation coefficient and multivariate regression analysis. The P < 0.05 was considered statistically significant.

Results

Among the constructs of health belief model, perceived severity, perceived benefits and self-efficacy, had significant and direct relationship and perceived barriers had a significant and reverse relationship with safe driving behaviors. According to the results, the constructs of health belief model predicted 17.3% of safe driving behaviors. Self-efficacy was the strongest determinant of safety behaviors (0.362 CI 0.098–0.625).

Conclusions

Increasing self-efficacy, reducing perceived barriers and highlighting benefits for the purpose of accepting safe behaviors can be considered as a principle in driving education and training. Also, increasing the perceived severity of adverse outcomes of RTAs and the susceptibility to these outcomes will lead to higher levels of safe driving behaviors.

The power of the health belief model (HBM) to predict water demand management: A case study of farmers' water conservation in Iran

The purpose of the present study was to explore the power of the Health Belief Model (HBM) to explain water conservation behavior in Northeastern Iran. The research population consisted of farmers who were farming in Neyshabur plain in Khorasan Razavi Province in northeast of Iran. A cross-sectional study was conducted among 235 farmers recruited using a multistage random sampling design. To collect data, the questionnaire was used which its validity and reliability were confirmed. The results of a structural equation modeling (SEM) indicated that perceived susceptibility, perceived benefits, and cue to action accounted for approximately 41% of the variance in farmers' water conservation behavior. Moreover, the perceived benefit was the strongest predictor of water conservation behavior, while perceived severity, perceived barriers, self-efficacy, and general beliefs not significant on behavior. These results confirmed the practicability and effectiveness HBM for examining water conservation behavior among farmers in Iran.

An application of the theory of planned behaviour to understand compliance with daytime running headlights law among motorcycle riders

Fatal motorcycle crashes are a persistent problem in Southeast Asia. In many respects, road safety experts have acknowledged conspicuity issue as one of the main causes of such accidents. To mitigate this deficiency, daytime running headlights (DRHs) law has been documented among the widely exercised countermeasures. The present study aimed to explore socio-psychological factors shaping intentions towards use of DRHs among Malaysian motorcyclists, because compliance level with this rule has remained constant since 1996 (80%). For this purpose, a model was constructed through the Theory of Planned Behaviour (TPB) to evaluate factors affecting motorcyclists' intentions towards compliance with DRHs law. A series of statistical analyses were performed to explain the effect of these factors and to predict degree of compliance with this rule. The model applied on a sample of university students (N = 398) demonstrated that the TPB components could significantly predict motorcycle riders' behaviours and degree of compliance with DRHs law. Moreover, it would be of assistance to policy-makers to recognize groups of motorcyclists more likely to cause an increase in traffic accidents. In general, regular educational campaigns were recommended to raise awareness regarding consequences of not using DRHs and also to nurture factors influencing motorcyclists' attitudes towards DRHs.

The role of perceived risk, reasons for non-seat belt use and demographic characteristics for seat belt use on urban and rural roads

Despite the well-documented benefits of seat belt use, a large number of drivers fail to fasten their seat belts in Iran. Efforts to improve seat belt use can be enhanced by identifying factors that motivate seat belt use. The main aims of this study were to assess the relationship between perceived risk of being ticketed and seat belt use among adult drivers on urban and rural roads and to identify reasons for not wearing a seat belt while exploring the relationship between these reasons and demographic information of adult drivers. An additional aim was to explain seat belt use on these two types of roads based on the perceived risk of being ticketed, demographic characteristics of drivers and the reasons for not wearing a seat belt. A total of 546 questionnaires were distributed including demographic information, items measuring the perceived risk of being ticketed and inquiry about the reasons for refusing to wear a seat belt. The results from valid questionnaires (n = 397) revealed that the perceived risk of being ticketed was not a predictor of seat belt use on urban and rural roads while controlling for age, gender, the influence of being ticketed and discomfort were predictors of seat belt use on urban roads. Meanwhile, older drivers, being ticketed in the past 3 years, having vehicle crashes in the past 3 years and discomfort were sole predictors of seat belt use on rural roads. Also, the findings suggested that there were differences between groups of respondents based on their demographic characteristics in the perceived risk of being ticketed and reported reasons for not wearing seat belts. The findings of this article extended the outcomes of previous studies in factors affecting seat belt use separately for drivers on urban and rural roads, which can help policy-makers promote seat belt use rates.

Understanding Information Security Behaviours of Tanzanian Government Employees

This article investigates security behaviours of employees using the Health Belief Model (HBM) as a theoretical lens. Given the fact that previous studies on security behaviours paid much attention to conscious information security behaviours; this article extends the HBM to study both habitual or automatic security behaviours (security habit) and conscious security behaviours of Tanzanian government employees. A structural equation modelling (SEM) technique was used for data analysis. The study found that, the intentions of government employees to practice information security behaviour is influenced by perceived severity, perceived susceptibility, perceived barriers, and cues to action and security habits. Their intentions, however, is not affected by perceived benefits and self-efficacy. Further, an employee's intentions and security habits has a significant effect on actual security practice. Generally, the extended research model enriches the understanding of the role played by both conscious and habitual security behaviours on information security behaviours of employees.

Predicting road safety behavior with implicit attitudes and the Theory of Planned Behavior

Introduction The Theory of Planned Behavior (TPB) is one of the most widely used psychological models when it comes to explaining road safety behaviors. Recently, studies have also been conducted from the perspective of dual-process models. However, the present is the first study on road safety behaviors that integrates both perspectives. The study evaluates the roles of both implicit attitudes and TPB constructs in the prediction of seatbelt use. Method A sample of 100 drivers completed: (1) a self-reporting instrument on seatbelt use, (2) a questionnaire addressing TPB constructs, (3) an indirect measure of attitudes (Implicit Association Test), and (4) a social desirability scale. Results Results suggest that both types of attitudes make a significant and quite similar contribution to the explanation of seatbelt use. Interestingly, implicit attitudes were a better predictor than explicit attitudes among participants reporting inconsistent seatbelt use. In addition, path analysis models suggested that implicit attitudes appear to be relatively independent of TPB constructs and have a direct effect on seatbelt use. Conclusion The findings advance the idea of adding implicit attitudes to variables from the TPB model in order to increase the explanatory power of models used to predict road safety behaviors. Practical applications Potential use of implicit attitude measures in the education and training of drivers are discussed.

Prediction of safe driving Behaviours based on health belief model: the case of taxi drivers in Bandar Abbas, Iran

BACKGROUND

Road accidents are among the main causes of mortality. As safe and secure driving is a key strategy to reduce car injuries and offenses, the present research aimed to explore safe driving behaviours among taxi drivers based on the Health Belief Model (HBM).

METHODS

This study was conducted on 184 taxi drivers in Bandar Abbas who were selected based on a multiple stratified sampling method. Data were collected by a questionnaire comprised of a demographic information section along with the constructs of the HBM. Data were analysed by SPSS ver19 via a Pearson's correlation coefficient and multiple regressions.

RESULTS

The mean age of the participants was 45.1 years (SD = 11.1). They all had, on average, 10.3 (SD = 7/5) years of taxi driving experience. Among the HBM components, cues to action and perceived benefits were shown to be positively correlated with safe driving behaviours, while perceived barriers were negatively correlated. Cues to action, perceived barriers and perceived benefits were shown to be the strongest predictors of a safe drivers' behaviour.

CONCLUSIONS

Based on the results of this study in designing health promotion programmes to improve safe driving behaviours among taxi drivers, cues to action, perceived benefits and perceived barriers are important. Therefore, advertising, the design of information campaigns, emphasis on the benefits of safe driving behaviours and modification barriers are recommended.

Knowledge, attitudes, and practice of drivers towards traffic regulations in Bandar-Abbas, Iran

Introduction

Traffic injuries are among the leading causes of death and disability in many countries. The knowledge, attitudes, and practice of drivers towards traffic regulations are key factors in decreasing traffic injuries and deaths. The objectives of this research were to study the knowledge, attitudes, and practice of taxi drivers towards traffic regulations in Bandar-Abbas, Iran, and to determine the relationships between demographic features and knowledge, attitudes, and practice of taxi drivers towards traffic regulations.

Methods

This cross-sectional study was done in 2014 in Bandar-Abbas, Iran (Hormozgan Province). To study the knowledge, attitudes, and practice of 241 intra-city taxi drivers towards traffic regulations, researchers developed questionnaires and a checklist. The chi-squared test was performed to determine the relationships between knowledge, attitude, and practice of drivers towards traffic regulations and demographic features.

Results

Among the 241 drivers, 50 of them (20.7%) thought that the seat belt could cause discomfort while driving, and 107 (44.4%) did not wear a seat belt while driving. The study determined that there was a significant difference between the knowledge and work experience of the drivers (p = 0.014). The 94 drivers (43.5%) in the 31–40 year age group had positive attitudes towards traffic regulations (among 216 drivers expressed positive attitudes) and 92 (44.4%) of the drivers in this age group had safe practices towards traffic regulations (among 207 drivers with safe practice).

Conclusion

Many of the taxi drivers in Bandar-Abbas had inadequate knowledge, less positive attitudes, and risky practices towards traffic regulations. Implementation of effective intervention programs may increase the taxi drivers’ knowledge, attitudes, and practices towards traffic regulations.

Seat belt use among car drivers in Iranian safe communities: An observational study

OBJECTIVE

The number of road traffic injuries and fatalities in Iran is high. The aim of the present study was to investigate the rate of drivers' seat belt use and a number of related factors in Kashmar, Bardaskan, and Khalilabad (Iranian Safe Communities).

METHODS

In 2014, driver observations were made at 48 road sites on intercity roads, main streets, side streets, and rural roads in these 3 cities.

RESULTS

A total of 10,255 vehicles were observed, with the overall rate of seat belt use being 51.8%. The rates in Kashmar, Bardaskan, and Khalilabad were 51.4, 56.3, and 47.7%, respectively. In Kashmar, the odds of seat belt use were higher among drivers who were female, older, and taxi drivers. Higher use was also found during the afternoon, and lower use was observed on rural roads. In Khalilabad the odds of seat belt use were higher among females, older drivers, taxis, and private car drivers. Seat belt use was also higher on weekends and during the morning but was significantly lower on rural roads. Similarly, in Bardaskan the odds of using a seat belt were higher among females, older drivers, taxis, and private car drivers. Seat belt use was also higher during the afternoon but was significantly lower on rural roads, in comparison to main streets and intercity roads.

CONCLUSIONS

The rate of seat belt use in these 3 cities was found to be low, despite these cities being designated as International Safe Communities. Therefore, seat belt promotion programs, tougher regulations, stronger enforcement, public awareness campaigns, and more research are needed to promote seat belt use in these Iranian cities.

Seat Belt Usage in Injured Car Occupants: Injury Patterns, Severity and Outcome After Two Main Car Accident Mechanisms in Kashan, Iran, 2012

Background:

Road traffic accidents (RTAs) are the main public health problems in Iran. The seat belts, which are vehicle safety devices, are imperative to reduce the risk of severe injuries and mortality.

Objectives:

The aim of the study was to evaluate injury patterns, severity and outcome among belted and unbelted car occupants who were injured in car accidents.

Patients and Methods:

This cross-sectional prospective study was performed on all car occupants injured in RTAs (n = 822) who were transported to hospital and hospitalized for more than 24 hours from March 2012 to March 2013. Demographic profile of the patients, including age, gender, position in the vehicle, the use of seat belts, type of car crashes, injured body regions, revised trauma score (RTS), Glasgow coma score (GCS), duration of hospital stay and mortality rate were analyzed by descriptive analysis, chi-square and independent t-test. P < 0.05 was considered significant.

Results:

A total of 560 patients used seat belts (68.1%). The unbelted occupants were younger (28 years vs. 38 years) and had more frequently sustained head, abdomen and multiple injuries (P = 0.01, P = 0.01 and P = 0.009, respectively). Also, these patients had significantly lower GCS and elongated hospitalization and higher death rate (P = 0.001, P = 0.001 and P = 0.05, respectively). Tendency of severe head trauma and low RTS and death were increased in unbelted occupants in car rollover accident mechanisms (P = 0.001, P = 0.01 and P = 0.008, respectively).

Conclusions:

During car crashes, especially car rollover, unbelted occupants are more likely to sustain multiple severe injuries and death. Law enforcement of the seat belt usage for all occupants (front and rear seat) is obligatory to reduce severe injuries sustained as a result of car accidents, especially in vehicles with low safety.

Dominant role of drivers' attitude in prevention of road traffic crashes: a study on knowledge, attitude, and practice of drivers in Iran

OBJECTIVE

Evaluating the relation between Iranian drivers' knowledge, attitude, and practice (KAP) regarding traffic regulations, and their deterministic effect on road traffic crashes (RTCs).

SETTING

Two cities of Tehran and Zahedan, Iran.

METHODS

A cross-sectional study was designed. Using a simplified cluster sampling design, 2200 motor vehicle drivers including 1200 in Tehran and 1000 in Zahedan were selected. Sixty locations in Tehran and 50 in Zahedan were chosen. In each pre-identified location, 20 adult drivers were approached consecutively. A questionnaire developed by researchers was filled by each participant. The questionnaire had four sections including items assessing the demographics, knowledge, attitude and practice of drivers toward traffic regulations. Logistic regression analysis was used to evaluate the relationship between the RTCs and KAP variables.

RESULTS

The study sample consisted of 619 (28.1%) occupational and 1580 (71.8%) private drivers. Among them, 86.4% were male. The median age was 33.6 ± 10.83. Drivers in Tehran and Zahedan had no significant differences between their mean scores of KAP items of the questionnaire. Higher knowledge, safer attitude, and safer practice were associated with a decreased number of RTC. After adjusting for possible confounders, increase of one standard deviation in attitude and practice scores (but not knowledge) resulted in 26.4% and 18.5% decrease in RTC, respectively. Finally, considering knowledge, attitude and practice of drivers in one model to assess their mutual effect, it was shown that only attitude is significantly associated with a decrease of RTC (OR=0.76, P=0.007).

CONCLUSION

Increase in attitude and practice accompanied with decreased number of RTCs in Iranian drivers. Specifically, drivers' attitude had the crucial effect. It is not knowledge and standard traffic education; rather it is how such education is registered as an attitude that translates what is being learned into actions. Without safer attitude, even safer self-reported practice will not result in lower RTCs.