Accident Analysis and Prevention 43 (2011) 646651 [612869]

Accident Analysis and Prevention 43 (2011) 646–651
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Accident Analysis and Prevention
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Taxi drivers’ views on risky driving behavior in Tehran: A qualitative study using
a social marketing approach
Mohsen Shamsa, Davoud Shojaeizadeha,∗, Reza Majdzadehb,c, Arash Rashidiand,e, Ali Montazerif
aDepartment of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran, Iran
bDepartment of Epidemiology and Biostatics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
cKnowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
dDepartment of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
eNational Institute of Health Research, Tehran, Iran
fDepartment of Mental Health, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
article info
Article history:
Received 7 June 2009Received in revised form10 September 2010Accepted 12 October 2010
Keywords:Social marketingConsumer researchFocus group discussionRisky driving behaviorTaxi driversabstract
The use of the social marketing approach for public health issues is increasing. This approach uses mar-
keting concepts borrowed from the principles of commercial marketing to promote beneficial healthbehaviors. In this qualitative study, four focus groups involving 42 participants were used in consumerresearch to explore taxi drivers’ views on the driving situation and the determinants of risky drivingbehaviors in Tehran, as well as to gather their ideas for developing a social marketing program to reducerisky driving behaviors among taxi drivers in Tehran, Iran.
Participants were asked to respond to questions that would guide the development of a marketing mix,
or four Ps (product, price, place and promotion). The discussions determined that the program productshould involve avoiding risky driving behaviors through increased attention to driving. They pointedout that developing and communicating with a well-designed persuasive message meant to draw theirattention to driving could affect their driving behaviors. In addition, participants identified price, placeand promotion strategies. They offered suggestions for marketing nonrisky driving to the target audience.
The focus group discussions generated important insights into the values and the motivations that
affect consumers’ decisions to adopt the product. The focus group guided the development of a socialmarketing program to reduce risky driving behaviors in taxi drivers in Tehran, Iran.
© 2010 Elsevier Ltd. All rights reserved.
1. Introduction
Road traffic crashes (RTCs) were the cause of about 1.2 mil-
lion deaths and more than 50 million injuries worldwide in 2000.By 2020, the number of RTC deaths will be more than 2 million.This increase will mostly occur in developing countries; in devel-oped countries, the RTC mortality rate will decrease by 30% ( Peden,
2005 ).
Iran has one of the highest rates of RTC mortality rates in the
world. Compared with the rate of 22.6 per 100,000 people world-wide and 13.9 per 100,000 people in the Eastern Mediterraneanregion, the RTC mortality rate in Iran was 30 per 100,000 peoplein 2000 ( Akbari et al., 2006 ). In 2006 in Iran, RTCs caused more
than 27,000 deaths and 270,000 injuries, and more than 5% ofthe gross domestic product (GDP) involved traffic crash costs. Thedisability-adjusted life years (DALYs) of RTCs in Iran were estimatedas 1,314,000 years for 2003, more than that for any other disease,
∗Corresponding author. Tel.: +98 2188989128; fax: +98 2188989129.
E-mail address: moshaisf@yahoo.com (D. Shojaeizadeh).like cardiovascular diseases and cancers ( Naghavi et al., 2004 ). More
than 230,000 deaths from road traffic injuries (RTIs) were recordedby Iranian organizations from 1997 to 2007. Although an increasein RTIs and the fatal RTI rate was recorded between 1997 and 2005,there was a 0.65% decline in fatal RTIs in 2006 and a 16.9% decreasein 2007 ( Rasouli et al., 2008 ).
Tehran’s Driving Department registered 4 million fined offenses
from March 2006 to March 2007 in Tehran, the capital of Iran. Notwearing a seatbelt was the most common risky driving behavior,followed by tailgating (following other vehicles too closely), notwearing a motorcycle helmet, talking on a cell phone while driving,overtaking from the wrong side, speeding, not driving between thelanes, weaving in and out of traffic, left deviation and changing laneswithout signaling ( Shams and Rahimi-Movaghar, 2009 ).
Making roads and vehicles safer and modifying risky driving
behaviors are the most prominent strategies for reducing RTCs(Mock et al., 2004 ). Risky driving, defined as “those patterns of driv-
ing behavior that place drivers at risk for morbidity and mortalityinvolving legal violations, but not alcohol or drug use,” is a main riskfactor for traffic crashes ( Jessor et al., 1997 ). Risky driving behav-
iors such as speeding, passing violations, tailgating, lane-usage
0001-4575/$ – see front matter © 2010 Elsevier Ltd. All rights reserved.
doi: 10.1016/j.aap.2010.10.007

M. Shams et al. / Accident Analysis and Prevention 43 (2011) 646–651 647
violations, right-of-way violations, illegal turns, and control signal
violations happen most frequently ( Karlsson et al., 2003 ). Chang-
ing risky driving behaviors, like other risky behaviors, requires “aconcept basis for helping to explain how the behavior occurs, howhealth education is conducted, and how health education affectsthis ongoing behavior” ( Modeste and Tamayose, 2004 ).
In public health, a variety of approaches, including education
and regulation, are applied to achieve behavior change. Educationwill be effective for groups who are considering a change or a behav-ior modification, but who do not have the necessary knowledge orskills. Enforcement is suitable for the entrenched groups who haveno desire to change. However, sometimes education falls short andregulation proves too extreme. Social marketing can be useful tobridge the gap between these two approaches and will be a goodsolution for those who are aware of the need to change but havenot considered changing. When an audience is ready to change butis still not able to adopt the behavior, social marketing can be usedto understand and address the specific needs of audience segmentsand can help them identify their specific barriers ( Maibach et al.,
2002 ).
Social marketing employs the principles of commercial mar-
keting to influence consumer behavior and decision making. Itattempts to influence voluntary behavior by offering or reinforc-ing incentives and/or consequences in an environment that invitesvoluntary exchange ( Rothschild, 1999 ). Exchange theory views
consumers as acting primarily out of self-interest as they seekways to optimize value by doing what gives them the greatestbenefit for the least cost. This theory reminds social marketersthat they must (a) offer benefits that the consumer (not the pub-lic health professional) truly values; (b) recognize that consumersoften pay intangible costs, such as time and psychic discomfortassociated with changing behaviors; and (c) acknowledge thateveryone involved in the exchange, including intermediaries, mustreceive valued benefits in return for their efforts ( Grier and Bryant,
2005 ).
Another core concept adopted from the commercial sector is
the marketing mix, also known as the four Ps: product, price, place,and promotion ( Kotler and Roberto, 1989 ). These key elements of
social marketing are central to the planning and implementation ofan integrated marketing strategy. Product refers to the set of ben-
efits associated with the desired behavior or service usage. To besuccessful, social marketers believe that the product must provide asolution to problems that consumers consider important and mustoffer them a benefit they truly value. For this reason, research isundertaken to understand people’s aspirations, preferences, andother desires, in addition to their health needs, to identify the ben-efits most appealing to consumers. The marketing objective is todiscover which benefits have the greatest appeal to the target audi-ence and to design a product that provides those benefits ( Kotler
and Roberto, 1989 ).Price refers to the cost or sacrifice exchanged
for the promised benefits. This cost is always considered from theconsumer’s point of view. As such, price usually encompasses intan-gible costs, such as diminished pleasure, embarrassment, loss oftime, and the psychological hassle that often accompanies change,especially when modifying ingrained habits. In setting the rightprice, it is important to know if consumers prefer to pay more toobtain “value added” benefits and if they think that products givenaway or priced low are inferior to more expensive ones ( Kotler and
Roberto, 1989 ).Place refers to the distribution of goods and the
location of sales and service encounters or the ideal location whereconsumers can obtain information about the product ( Kotler and
Roberto, 1989 ).Promotion is often the most visible component of
marketing. Promotion includes the type of persuasive communi-cations marketers use to convey product benefits and associatedtangible objects and services, pricing strategies, and place com-ponents ( Kotler and Roberto, 1989 ). Promotional activities mayencompass advertising, public relations, printed materials, pro-
motional items, signage, special events and displays, face-to-faceselling, and entertainment media ( Walsh et al., 1993 ).
Social marketing has been successfully used to promote some
important health behaviors: for example, condom usage for pre-venting sexually transmitted disease and HIV in some countries(Agha et al., 2001; Cohen et al., 1999; Futterman et al., 1998;
Lamptey and Price, 1998 ), increased physical activity ( Wong et al.,
2004; Westhoff and Hopman-Rock, 2002 ) and helmet usage among
bicyclists ( Morris et al., 1994; Ludwig et al., 2005 ). In a system-
atic review done by Trifiletti et al. (2005) , an intervention based on
social marketing for increasing helmet usage was discussed. Smith
(2006) studied two social marketing programs, “Click It or Ticket!”
for promoting seatbelt usage and “Friends don’t let friends drivedrunk!” for persuading drivers to avoid drunk driving.
In recent years, traffic injury prevention has been one of the pol-
icy priorities in Iran, and Iranian administrations have also maderoad safety goals one of their main policies. A number of educa-tional, structural and enforcement actions have been considered.Some of these actions include using mass media to communicatepersuasive messages and arouse public attention; implementingeducational programs in schools; using speed cameras; increasingthe police presence in recent years; and making changes at the legallevel, including implementing a road safety law and approving newpenal legislation for offenders. However, focusing on civilians’ par-ticipation to enhance the effectiveness of road traffic policies andactions has not been considered sufficiently. Searching the Iranianscientific databases for documentation of interventions designedto reduce RTCs through consumer-oriented models like social mar-keting produced no results.
Hence, the purpose of this qualitative study is to investigate
taxi drivers’ views about driving situations and determinants ofrisky driving behaviors in Tehran and to obtain their suggestionsfor intervention proposals and the optimal components of a mar-keting mix for developing an intervention to reduce risky drivingbehaviors. This knowledge may help public administrators takeinto account the expectations, perceptions and needs of the targetgroup when designing and implementing policies, messages andactions.
2. Methods
The study was conducted in Tehran, the capital of Iran, which
has a population of 7,800,000, making it the country’s largest city.Tehran was selected as the study city because it is considered thebest large city in Iran for road safety, road conditions, driver literacylevel and income, and law enforcement. Tehran is also the best cityfor comparison purposes because it is the capital and has driversand vehicles from all over the country.
Taxi drivers, a large group of commercial drivers of more than
100,000 people, play a main role in the public transportation systemin Tehran. They are the most active drivers and are usually contin-uously driving for almost the entire day. Although their absolutenumbers are not substantial when compared with private drivers,they have more exposure to roads, more communication with pas-sengers and more accessibility to measurements of the plannedinterventions. In 2006, two municipal districts in Tehran had thehighest rates of taxi crashes ( Shams and Rahimi-Movaghar, 2009 ).
We purposefully selected taxi drivers from these two districts forthe qualitative study. The Taxi Drivers Organization in Tehran gaveus the address and phone number of taxi drivers from these twodistricts, and participants were randomly recruited through thislist. They were formally notified by telephone.
All such taxi drivers in the districts were male, and we had no
strong a priori hypothesis for the purposeful selection of the par-

648 M. Shams et al. / Accident Analysis and Prevention 43 (2011) 646–651
Table 1
Question guide related to focus group discussions.
Questions Components related to
social marketing four Ps
How do you think about current
driving situation in Tehran? Is itsatisfactory?–
What about the role of taxi drivers in
driving situation in Tehran? Do youthink they drive like others?–
In your opinion, which driving
behaviors are risky? Can you namethem?–
Do taxi drivers commit risky driving
behaviors like others?–
In your view, why do these behaviors
happen among taxi drivers?Product
What is your suggestion for preventing
risky driving behaviors among taxidrivers?Product
What do you think about the barriers
for executing your suggestions?Price
What are the most suitable places for
executing your suggestions?Place
What do you think about the ways by
which we can promote the suggestedinterventions? What is your ideaabout media advertisement? Howabout the persons who affect on taxidrivers?Promotion
ticipants at this stage. In total, 48 taxi drivers were invited and
42 agreed to participate. They were divided into four groups. Themeetings with the taxi drivers were held at the School of PublicHealth, Tehran University of Medical Sciences. The sessions lasted90–120 min. We paid an incentive equivalent to 2 h of driving toeach participant at the end of the sessions.
We had envisaged forming further group discussions if needed;
however, no new theme emerged in the fourth discussion group,and data collection stopped at this stage.
Before participating in the focus group, each driver was asked
to read and sign the informed consent form indicating agreementto participate. It was emphasized that attending these sessions wasoptional and if a person did not want to continue, he could leavethe group. None of the subjects withdrew from the study duringthe focus group discussion. They were also asked to fill out a shortsurvey including their background and demographic information.
The guide questions for the focus groups are shown in Table 1 .
This guide included some questions to begin the discussions andsome items related to marketing mix components that were con-firmed by several experts in the traffic and social marketing fields.The first author (MS), the moderator, and two trained note tak-ers recorded the data obtained from the discussions, including thenotes recorded on a whiteboard, tape recordings and handwrittennotes taken during each focus group. The discussions were analyzedseparately for each group.
Qualitative analysis was used to analyze the data generated
from the focus groups. All audio tapes were transcribed verbatimand analyzed by a researcher (MS) using the classical long-tableapproach ( Krueger and Casey, 2000 ). The original transcripts were
copied, and these copies were cut, pasted and categorized with acorresponding color-coding scheme. The original transcripts werereferred to frequently to ensure the correct context of quotes.The main topic areas of “driving situation in Tehran”, “determi-nants of risky driving behaviors”, “suggestions for interventionproposals”, “price”, “place” and “promotion” were analyzed foremerging themes, and descriptive summaries and comparisonsbetween groups and across the different time points were made.The moderator reviewed the summaries to confirm the analysis.Table 2
Demographic characteristics of the participants.
Variables Numbers Percent
Age (years)
20–34 4 9.635–49 30 71.450–64 8 19
Literacy
Reading and writing 4 9.6Elementary school 2 4.8Junior high school 14 33.3High school 18 42.9University 4 9.6
Years since their driving license
5–10 4 9.610–20 16 38>20 22 52.4
Years since starting taxi driving
<5 6 14.35–10 14 33.310–20 12 28.6>20 10 23.8
Working hours per day
4–8 2 4.8>8 40 95.2
3. Results
Four focus group discussions were held involving a total of 42
participants; the participants were divided into four groups—twogroups of 10 and two groups of 11. All participants were menbecause female taxi drivers are rare in Iran. The mean age was46.2 ( ±12.2) years and 76% had attended or completed junior high
school and high school. The mean duration since obtaining theirdriver’s license was 18.7 years (SD = 3.4), while the mean year sincestarting taxi driving in Tehran was 9.7 years (SD = 1.1). Almost alldrivers reported that they were working more than 8 h a day. Theparticipants’ demographic characteristics are given in Table 2 . The
results are presented with all groups combined together becausethere was a general agreement between groups. Any differencesthat appeared are noted.
3.1. Driving in Tehran and the role of taxi drivers
When asked about the current driving situation in Tehran, the
participants used statements such as “It’s very bad!”, “It’s awful!”and “It’s difficult!”, showing they were not satisfied with drivingin the city. They complained about road and vehicle deficiencies,as well as bad driving. Regardless of their complaints about thedriving habits of other driver groups, especially private drivers andmotorcyclists, the majority of the taxi drivers rated their own driv-ing as much better than that of others. Even an old, experienceddriver denied any risky driving behaviors among taxi drivers: “Taxi
drivers don’t drive risky. Their job is driving and they aim at keepingtheir passengers safe.” However, most of the participants accepted
that taxi drivers, like other drivers, commit risky driving behav-iors and that they must not be excluded. One of the participantsbelieved that “In addition to the general risky driving behaviors, taxi
drivers occasionally do some specific behaviors, too.” They pointed out
stopping outside the stations, picking up passengers at the wrongplace and while moving, and driving angrily as examples of thesespecific behaviors.
When asked about the groups who could influence others’ driv-
ing behaviors, most of them referred to taxi drivers as a potentialexample. They highlighted the large number of taxi drivers, thefact that they were trained and professional, and the fact that theydrive continuously for almost an entire day or even through thenight in different parts of the city. One of the participants believedthat “Most of us are experienced and skilled in driving. We can be an

M. Shams et al. / Accident Analysis and Prevention 43 (2011) 646–651 649
example for other drivers.” However, the taxi drivers believed that
playing such an important role would require avoiding risky drivingbehaviors.
3.2. Determinants of risky driving behaviors
Participants pointed out that the determinants of risky driving
were multiple and complex. They listed a large number of mutu-ally interrelated factors associated with committing risky drivingbehaviors. They knew the risky driving behaviors and could namethese behaviors easily. Like traffic experts and scientific sources,they listed the following as risky behaviors: not using seatbelts,speeding, wrong overtaking, left deviation, changing lanes withoutsignaling, talking on a cell phone while driving, not driving betweenthe lanes, tailgating (or following vehicles too closely), weaving inand out of the traffic, and driving under the influence of alcohol anddrugs.
In their opinion, there is no effective education before one
obtains a driving license. They also complained about the lackof special educational programs before and continuous educationafter starting their job as taxi drivers.
The participants felt that the role of the police is not satisfactory.
A young taxi driver said, “Police officers just attend after crashes.”Another one believed, “Using sanction and fear, police intend toreduce risky driving, but they are not enough.” Participants were infavor of sanction measures just for serious or repeat offenders. Forthese cases, they would be in favor of high penalties such as lossof license or heavy fines. While discussing the necessity of policecontrol, one of the participants asked an important question. Heasked, “Tehran has more than 10 million people and 3 million motorvehicles.” If we are looking to reduce driving offenses using onlythe police, how can we provide so many police officers?” When wequoted this in other groups, some participants used the term “ourown police”. An experienced driver said, “We are able to be our ownpolice, a police officer who guides but does not have any tickets inhis hands!”
Participants named some structural elements that influence
driving behaviors. The unsuitable design of streets and highwaysand the existence of more vehicles than the actual capacity of theroads result in traffic jams. A young driver said, “Traffic jams are
a routine event in Tehran. Streets are overcrowded and taxi driverswant to escape and save their time. It usually results in risky driving.”Another driver pointed out that traffic jams might result in angri-ness : “Overcrowded streets make taxi drivers get angry, and angriness
may result in offenses and accidents.” Participants complained about
the surface of the streets, too. One taxi driver said, “Roads and streets
are full of holes. Taxi drivers have to put on the brakes or change theroute suddenly. As a result, cars at their back may hit them.”
They pointed to some social determinants, like inflation, lack of
insurance, low income, unemployment, addiction and so on, as themain elements related to risky driving as well as traffic crashes. Anold and experienced driver said: “ I know about the driving rules, but
there are thousands of thoughts in my mind. Economic problems resultin lack of my concentration on driving.” Another driver said , “The
majority of taxi drivers have to work hours and hours to earn enoughmoney, and tiredness, as a main factor for risky driving behaviors, iscommon.”
3.3. Intervention proposals as products
The participants emphasized education as an effective strategy
for reducing risky driving behaviors. However, the participants didnot mean just raising awareness. One of the participants believed,“We do not have any effective education. If we had been trained
through better training programs, before and after starting our job astaxi drivers, we would have committed less risky driving behaviors.” Anexperienced driver said , “Taxi drivers need special education. Know-
ing about the traffic rules is not enough .” A driver with a high literacy
level suggested, “We must learn how to control our feelings, manage
our stress and draw our attention to driving.”
In their opinion, publicity and information based on emotional
impact do manage to produce changes in their behaviors. They sug-gested developing well-developed persuasive messages aimed atdrawing the attention of drivers to their driving. “ Sometimes an
object can be used as a reminder and it can draw our attention todriving. This reminder could help me to pay attention to my driving.”
All of the drivers agreed with the role of the mass media in
persuading drivers to avoid risky driving. They considered radioand television as two main effective types of mass media. How-ever, their views showed their dissatisfaction with playing theirexpected roles in Iran. They complained about the lack of radioadvertisements persuading drivers to drive correctly. Additionally,they found related TV animations more suitable for children. Oneof the participants said, “If the documentary films were made about
the real events related to risky driving behaviors, it would be moreeffective than animations.”
Some participants suggested increasing the fines. A young
driver said, “ If a taxi driver knows that he should pay heavy fines for
his violation, he will avoid committing it. ” However, the majority
opposed this proposal. They believed that economic sanctions giveone the impression that it does not matter what you do: as long asyou pay, you can keep on doing it. An experienced taxi driver said,“When a taxi driver commits an offense intentionally, he has to payhis daily income for the fines. This will make him angry, and drivingangrily is worse.”
Another driver believed, “A fined taxi driver may act as an
entrenched driver, and therefore, changing him will be harder.”
All of the participants believed that providing facilities such as
specific stations for taxis could decrease the rate of risky drivingbehaviors by taxi drivers. They agreed with this idea: “ When taxi
drivers have no taxi station or their stations are located in improperplaces, they have to stop at other places and commit some risky drivingbehaviors.”
3.4. Price or barriers to accepting the recommended interventions
Although several costs were identified, lack of time for attending
educational programs was the greatest barrier for most partici-pants. Most believed that their daily schedules were too full toparticipate in educational programs. One of the participants said,“Taxi drivers do not have enough time to participate in classes. I wishTehran’s Taxi Drivers Organization would develop and disseminate thisinformation in the form of messages or pictures.”
Some participants pointed out that avoiding risky driving behav-
ior may result in spending more time en route and less daily income.If taxi drivers do not commit speeding, overtaking, tailgating andother risky behaviors, they may earn less money.
With further probing during focus group discussions, ideas for
overcoming these limitations were elicited. To make the timerequired acceptable, instead of using an official place such as taxidrivers’ offices, programs could be launched regionally or even atwork, along the taxi routes and in taxi stations where drivers waitfor passengers. To justify making behavioral changes, the benefitsgained from reducing their monetary and nonmonetary costs fromtraffic crashes and playing the social role of serving as examples ofnonrisky driving were emphasized.
3.5. Suitable places for implementing the recommended
interventions
Participants were asked to describe their preferred locations for
implementing the suggested interventions. For educational pro-

650 M. Shams et al. / Accident Analysis and Prevention 43 (2011) 646–651
grams, most preferred informal places. Although they believed that
an official place such as the taxi drivers’ offices was better, taxidrivers cannot attend programs there easily. For communicatingpersuasive messages, the most suitable locations were thought tobe the routes of taxi drivers along streets and highways, at taxistations and inside cars.
3.6. Promotion
In this study, all focus groups highly favored avoiding risky
driving behaviors. The participants were asked to describe indi-viduals who had affected their driving behaviors, controlled theinformation flow and played an important role in communication,education and information processes. They pointed out their super-visors and experienced and trusted drivers who are elected bytaxi drivers on the routes. If these opinion leaders are informedand educated, they will be able to influence other drivers’ riskybehaviors.
All participants believed that radio and television were the
best educational and informational channels for taxi drivers. Theyfavored using two local radio channels, Radio Payam and RadioTehran, to communicate persuasive messages and information.
Most drivers pointed out using reminders to avoid risky driving
behaviors. A participant said, “ Most taxi drivers know about risky
driving behaviors and their consequences, but they need motivationto avoid risky driving behaviors. When he is reminded of the ben-efits of avoiding risky driving behaviors and thinks that it is betterfor him to drive correctly, he will do that voluntarily .” In the focus
groups, creating well-developed print materials to communicatepersuasive messages to target group was suggested. For example,stickers installed before taxi drivers’ eyes, booklets and pamphletswith attractive pictures and information, street billboards, and theexternal surface of the vehicles can be reminders for paying atten-tion to driving. In this way, taxi drivers can see these messages andconcentrate on their own driving. The main themes and the relatedprogram components are shown in Table 3 .
4. Discussion
To facilitate individual or community-based changes, health
education alone is insufficient, and marketing concepts must beapplied with a stronger consumer orientation. The wants and needsof the target audience, as well as the challenges, likes, dislikes, andfears related to a health problem and its determinants, must beconsidered. The consumer research phase of a social marketing pro-gram is known as consumer analysis by Neiger in the SMART (SocialMarketing Assessment and Response Tool) model, as consumer ori-entation by Lefebvre and Flora, and as formative research by Bryant(Neiger et al., 2003 ). Learning about demographic, psychosocial and
behavioral variables through qualitative and quantitative methodsis necessary for segmenting the primary general target audienceinto smaller and more homogenous subgroups and developing theparticular interventions needed to modify risky behaviors. In thisway, a more effective intervention can be designed and imple-mented ( Maibach et al., 2002 ). We selected taxi drivers as a specific
segmented target group.
In this study, taxi drivers’ views on the current driving situa-
tion and determinants of risky driving in a large Iranian city, aswell as their ideas about the usual interventions to reduce riskydriving behaviors, were explored. The focus groups enriched ourunderstanding of consumers’ ideas about driving behaviors. Taxidriver s – a large group of commercial drivers in Tehran – are the
most active drivers and usually drive continuously for almost anentire day. About 100,000 taxi drivers are operating on the streetsand highways of Tehran. Note, however, that because of the smallTable 3
Main themes and related program components in focus group discussion.
Main themes Program components
Driving in Tehran andthe role of taxi driversDissatisfaction with driving in
TehranTaxi drivers as an example forother driversNot doing risky drivingbehaviors is necessary forplaying this role
Determinants of risky
driving behaviorsLow capacity and quality roads
Socioeconomic problems(inflation, lack of insurance,low income, unemployment,addiction etc.)Insufficient police controlLack of especial andcontinuous educationInsufficient mass mediainvolvement
Interventions proposals
as productsSpecial training programs to
learn how to control theirfeelings, manage their stressesand draw their attention todrivingPublicity and informationthrough mediasIncreasing the finesProviding facilities such ascertain stations for taxies
Barriers to acceptance therecommended interventionsLack of time for attending the
educational programs
Suitable places for
implementing therecommendedinterventionsInformal places such as the
route of taxi drivers inhighways and streets, taxistations and internal space oftaxiesOfficial place such as taxidrivers’ offices
The best channels for
communicating andpersuading taxi driversTV and regional radio channels
such as Radio Payam and RadioTehranPrinted media like booklets,pamphlets, and stickersTaxi route supervisors as thetaxi drivers’ opinion leaders
and nonrandomized sample, generalization from this study should
be done with caution.
In a similar study done in Ghana, bus and minibus drivers were
selected to investigate their knowledge and attitudes in order toprovide information that could subsequently be used to developanti-drunk driving social marketing messages built upon the intrin-sic values and motivations of these drivers. They considered focusgroup discussions and qualitative studies to design an interventionbased on social marketing to reduce drunk driving ( Asiamah et al.,
2002 ).
In another qualitative study, young people’s perception of traffic
injury risk, prevention and enforcement measures were investi-gated. The researchers conducted interviews with key informantsand held focus group discussions involving young people and con-cluded that the effectiveness of interventions to reduce trafficinjuries could be improved by taking the recipients’ perceptionsinto account ( Ramos et al., 2008 ).
The taxi drivers who participated in our study expressed con-
cerns and were grateful to have been consulted. They were awarethat the current driving situation in Tehran should be improvedand that risky driving behaviors, as an important cause of trafficcrashes, should be changed. They knew and could list these behav-iors correctly and pointed out that taxi drivers often committedrisky driving. Another finding was the idea that the taxi driversheld about their potential role as an example for other drivers. They

M. Shams et al. / Accident Analysis and Prevention 43 (2011) 646–651 651
pointed out that playing this role would mean avoiding risky driv-
ing behaviors. Therefore, this fact might be an incentive for themto drive safely and correctly.
The focus group research enabled us to focus on developing
ways to reduce risky driving behaviors among taxi drivers. Mostpreferred some form of specialized educational program and inter-ventions using well-developed persuasive messages to draw theirattention to driving. In their opinion, communication skills training,stress management techniques and concentrating on driving mightbe more effective than the usual educational methods targeted atraising knowledge. The taxi drivers emphasized that they preferredto pay attention to a persuasive message that could encourage themto concentrate on their driving. However, the best way to presentnonrisky driving so that it appears better than risky driving behav-iors is to promote it as a way to be an example for other drivers andas a way to reduce the monetary and nonmonetary costs related totraffic crashes. Most participants emphasized that marketing mate-rials should consider the literacy level and the potential role of taxidrivers in the current driving situation. Most were opposed to thetwo main strategies that, in their opinion, the administration uses:sanctions and fear. They were only in favor of heavy fines for veryserious and repeated offenses.
The participants preferred to receive the materials and messages
in situations where they did not need to pay monetary, time orembarrassment costs. In their opinion, time was the most promi-nent barrier to accepting the interventions because setting asidetime for interventions would decrease their income significantly.So, they suggested using taxi routes along streets and highways,taxi stations, regional offices and even the internal space of taxis asproper places for introducing products and programs to improvedriving behaviors.
Using persuasive messages in the form of stickers installed
before the eyes of drivers and booklets or pamphlets introducedin a suitable place like stations and the internal space of taxis wereconsidered the main strategies for persuading drivers to avoid riskydriving behaviors. Another strategy favored by most participantswas taxi route supervisors acting as opinion leaders for influenc-ing drivers. Taxi route supervisors are usually experienced drivers,and their colleagues respect them and obey their orders. Insteadof working on all taxi drivers, a very difficult and expensive pro-cess, we can educate these opinion leaders and provide the neededinformation to change their own and their colleagues’ behaviors.
The essential components of social marketing – product, price,
place, and promotion – must be considered and fully addressed fora social marketing program to be successful; this can only be donethrough consumer research. Because qualitative data are essentialcomponents in comprehensive consumer research, focus groupscan be used as a qualitative research tool and can play a valuablerole in enhancing consumer research. As a result, a social marketingprogram was developed to promote the avoidance of risky drivingbehaviors in Tehran, Iran.
4.1. Study limitations
There are caveats to this study. Focus groups are not repre-
sentative of an entire population, and participants’ responses maybe influenced by the responses of others. Therefore, due to thesmall and nonrandomized sample, generalization from this studyshould be done with caution. In addition to the drivers from the twoselected districts with high rates of traffic crashes, there are othertaxi drivers whose perceptions and views on risky driving behaviorsmay be different. If public administrations want to design a socialmarketing program for all of Tehran, they need to know about allof the groups, including commercial and private drivers. The focusgroup is not a tool for testing hypotheses; it should be used to iden-tify issues and themes. For these reasons, the study’s focus groups
were conducted in conjunction with quantitative data collection.
Acknowledgements
We appreciate the assistance of Tehran Police Safety Driv-
ing Department for preparing the related data and Tehran’s TaxiDrivers Organization for identifying taxi drivers for participationin the focus group discussions.
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