LAUSR

Abstract Introduction Not giving way to ambulances leads to delays in rescuing patients and sometimes may even cause traffic collisions, which is a public health issue of great concern in many countries including China. This study aimed to examine the socio-psychological factors underlying drivers’ unwillingness to give way to ambulances on urban roads. Method Data were collected from 423 drivers using an online survey. A self-reported questionnaire based on an extended theory of planned behavior (TPB) model was used to measure drivers’ behavioral willingness, attitude, subjective norms, perceived behavioral control, moral norms, anticipated action regret, and anticipated inaction regret. Descriptive statistics, Pearson correlation analysis, and hierarchical regression analysis were conducted to analyze the data. Results The mean age of the drivers was 36.38 (SD = 11.98) years, and there were 249 male and 174 female drivers. Better educated drivers had a lower unwillingness to give way to ambulances (M = 2.31, SD = 0.699) than less educated drivers (M = 2.97, SD = 0.826), and drivers having emergency medical services (EMS) experience using ambulances had a lower unwillingness to give way to ambulances (M = 2.37, SD = 0.732) than drivers without related experiences (M = 2.93, SD = 0.838). Attitude, perceived behavioral control, moral norms, anticipated action regret, and anticipated inaction regret were all significantly associated with drivers’ self-reported unwillingness to give way to ambulances while subjective norms were not. Conclusion The TPB was useful for understanding drivers' unwillingness to give way to ambulances. Adding the factors of moral norms and anticipated regret could enhance the interpretive power of the TPB. The findings can be used to design more effective interventions against drivers’ unwillingness to give way to ambulances on urban roads.