title: Effectiveness of media awareness campaigns on the proportion of vehicles that give space to ambulances on roads: An observational study.
abstract: OBJECTIVE
  The findings of the Health Care in Danger project in Karachi suggests that there is presence of behavioral negligence among vehicle operators on roads in regards to giving way to ambulances. A mass media campaign was conducted to raise people's awareness on the importance of giving way to ambulances. The main objective of this study was to determine the effectiveness of the campaign on increasing the proportion of vehicles that give way to ambulances.
  
  
  METHODS
  This was a quasi-experimental study that was based on before and after design. Three observation surveys were carried out in different areas of the city in Karachi, Pakistan before, during and after the campaign by trained observers who recorded their findings on a checklist. Each observation was carried out at three different times of the day for at least two days on each road. The relationship of the media campaign with regards to a vehicle giving space to an ambulance was calculated by means of odds ratios and 95% confidence intervals using multivariate logistic regression.
  
  
  RESULTS
  Overall, 245 observations were included in the analysis. Traffic congestion and negligence/resistance, by vehicles operators who were in front of the ambulance, were the two main reasons why ambulances were not given way. Other reasons include: sudden stops by minibuses and in the process causing obstruction, ambulances not rushing through to alert vehicle operators to give way and traffic interruption by VIP movement. After adjustment for site, time of day, type of ambulance and number of cars in front of the ambulance, vehicles during (OR=2.13, 95% CI=1.22-3.71, p=0.007) and after the campaign (OR=1.73, 95% CI=1.02-2.95, p=0.042) were significantly more likely give space to ambulances.
  
  
  CONCLUSIONS
  Mass media campaigns can play a significant role in changing the negligent behavior of people, especially when the campaign conveys a humanitarian message such as: giving way to ambulances can save lives.
authors.affiliation: Dr. Shiraz Shaikh. MBBS, FCPS. Assistant Professor, APPNA Institute of Public Health, Jinnah Sind Medical University, Karachi, Pakistan.
authors.forename: Shiraz
authors.initials: S
authors.lastname: Shaikh
authors.affiliation: Prof. Lubna A Baig. MBBS, FCPS, PhD. Dean, APPNA Institute of Public Health, Jinnah Sind Medical University, Karachi, Pakistan.
authors.forename: Lubna A
authors.initials: LA
authors.lastname: Baig
authors.affiliation: Maciej Polkowski. Head of "Health Care in Danger" (HCID) Project, International Committee of the Red Cross, Pakistan.
authors.forename: Maciej
authors.initials: M
authors.lastname: Polkowski
keywords: Ambulances; Emergency care; Mass media campaign