Percent of nonusers who intend to adopt a certain practice in the future
This indicator measures the intention of non-users to adopt a behavior. “Non-users” are those individuals in the intended audience who do not (yet) practice the behavior in question. “Intend” is operationally defined as the percent of nonusers who answer affirmatively to the question, “Do you intend to ___ (practice a specific health behavior) in the future.” Programs should define the period, for example, (e.g., in the next three, six, or twelve months). “Practice” refers to the desired result the program is trying to achieve among members of the population in question.
This indicator is calculated as:
(Number of audience members who intend to adopt the behavior in the specified reference period/Total number surveyed in intended audience) x 100
Self-report from surveys. As with attitude, if researchers use a five-point Likert scale, they must decide whether to combine “strong intent” with “some intent” to arrive at the total percentage intending to adopt the desired behavior.
This indicator can be disaggregated by audience characteristics (age, sex, geographic location, rural/urban status, or other characteristics of interest to the program).
National, regional, or local sample surveys with members (preferably a representative sample) of the intended audience
The decision to practice a given behavior (e.g., deliver at a hospital, breastfeed one’s baby) can take the form of a statement of intent to act at some point in the future. The value of measuring intention can vary depending on the stage of the program or on the audience in question. For example, if the behavior is still new and infrequently practiced, and the media are trying to create awareness, increase knowledge, and change attitudes, intention to use is an important step to behavior change. In programs where the audience is not yet in a position to act (e.g., adolescents being encouraged to delay initiation of sex), intention to use contraception when appropriate is a good outcome indicator for the short term because long-term behavior change is not available. Another useful indicator for adolescents is intention to delay sexual debut.
Intention is relevant among members of the target audience that do not yet practice the behavior. Although “intention” is a behavioral response that could be classified as an intermediate outcome, it tends to be used in connection with the evaluation of social and behavior change communication (SBCC) programs as an important step between non-use and use, which behavioral studies often overlook.
Evaluators may also measure degree of intention or of probability of adopting the practice by asking members of the audience to respond in terms of a five-point word scale of likelihood (definitely, probably, unsure, probably not, and definitely not).
An alternative approach is to combine two types of intent to arrive at a single desired behavior (e.g., safer sex). Communication programs directed at youth might measure the percent of the audience that report high intention to abstain from sex before marriage or that definitely intend to use a condom every time they have sex.
Mass media generally focus on creating awareness of a benefit or sparking a latent need: (Do you want your baby to be healthier?) Evaluators can measure the ability to create a felt need by the reported intention (“I intend to breastfeed my baby exclusively for six months because it will make him/her healthier”). Based on theories of persuasion, the messages designed for reproductive health SBCC interventions usually attempt to link practice to new benefits/values, to increase the importance of those values, and/or to strengthen the belief that such benefits will indeed result from the practice in question. Evaluators use focus group discussions or in-depth interviews with audience members to identify the most important attitudes related to intention and practice of the behavior.
Intention usually mediates the relationship between attitudes and behavior. Not all individuals who have intentions can act on them immediately. In the case of HIV prevention programs, some members of the population may wish to get tested for HIV, but may not have access to a testing facility. Communication programs can affect the attitudes and the intention to change behavior (get tested), without affecting behavior. Intention, as a step in the behavior change process, is “necessary but not sufficient” to predict with certainty behavior change.
communication, attitude, behavior