Intention as an indicator for subjective need: A new pathway in need assessment.

Background: The current analyses focus on the need for services from the perspective of individuals considering preventive measures. A new approach imported from social and health psychology is used for assessing subjective need. This indicator is used for predicting actual health behaviour under field conditions and simultaneously other relevant background variables are taken into account.

Methods: A mail survey was conducted prior to the start of a coaching program for teachers. A sample of n = 949 respondents were queried about mental distress and their intention to participate in the program. This intention to participate and actual attendance were taken as outcome variables in logistic regression analyses adjusted for relevant background variables.

Results: Intention and participation in the coaching program three months later were associated with an unadjusted OR of 90.1 (95% CI: 39.2 - 207.0) for male teachers. For female teachers the crude effect was OR = 80.0 (95% CI: 45.7 - 140.1). The positive predictive value (PPV) was 96.4% among males and 94.5% among females. Adjusting for covariates results in higher values. Among female, but not among male teachers, the participation depended on psychological distress as assessed by the General Health Questionnaire (GHQ).

Conclusions: There is strong evidence for using subjective need as an additional component in assessing the need for services and for predicting actual health behaviour. But it needs to be confined to intended behaviour which is under behavioural control.