Attitude and Behavior of Road Users Responding to EMS Ambulances in Developing Countries: a Cross-sectional Study.

Introduction: Emergency medical service (EMS) providers use ambulance lights and sirens (L&S) to expedite their travel and to warn road users. This study aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use.

Methods: This was a cross-sectional survey distributed to road users in Northern Jordan. The questionnaire included 19 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants' responses and assessed the association between demographics and attitude statements using logistic regression.

Results: A total of 1302 questionnaires were available for analysis. The mean age of participants was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) would perform inappropriate actions in response to EMS ambulances with L&S in use. The multivariate logistic regression model showed that being female (OR: 0.63; 95% CI = 0.48-0.81), more educated (OR: 0.68; 95% CI = 0.53-0.86), or public transport driver (OR: 0.55; 95% CI = 0.34-0.90) was significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as following the passing by EMS ambulances.

Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances and many engage in risky driving behaviors, perhaps due to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior.