Reviving the conceptual intricacies of the intention construct in health research: recommendations and future directions

Abstract

Background: Intention has been an important concept in health behaviour theory/research by explaining and predicting behaviour, providing a keystone for intervention and serving as a critical comparison for the relative value of volitional and nonconscious factors to behaviour. Nevertheless, we propose that the intention concept has a double-barreled definition that was identified but not adequately addressed during the inception of popular intention-based models. Intention can mean a decision to perform a behaviour or not (dichotomous) and/or the commitment (continuous) to enact a behaviour. The purpose of this review was to overview the definition-level complexity of intention both from researcher and lay perspectives, discuss the operational and functional assumptions of intention based on this complexity, and provide recommendations for how to reduce this complexity moving forward. Methods: A search of seven dictionaries and research articles published between January 2012-2017 using Google Scholar with the in-title search terms: intention AND health was conducted. Within the relevant publications, citations for ‘intention’ were tracked to the original sources of conceptualization. Results: The two meanings of intention were present and prevalent across researcher and lay definitions. Further, we demonstrate that these separate meanings have different measurement requirements and are situated in different intention-based models. Discussion: We suggest that decisional intention be used to denote the direction meaning of intention and intention strength should be used to denote the intensity of commitment. We suggest that holding to these terms will improve measurement, theory testing, and intervention practices in health behaviour research that employs an intention construct.