{"id":222,"date":"2016-12-19T11:33:37","date_gmt":"2016-12-19T11:33:37","guid":{"rendered":"http:\/\/practicalhealthpsychology.com\/?p=222"},"modified":"2025-11-04T14:50:11","modified_gmt":"2025-11-04T14:50:11","slug":"does-money-really-change-everything-using-financial-incentives-and-disincentives-to-change-health-behaviours","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/cz\/2016\/12\/does-money-really-change-everything-using-financial-incentives-and-disincentives-to-change-health-behaviours\/","title":{"rendered":"Opravdu mohou pen\u00edze zm\u011bnit v\u0161echno? Finan\u010dn\u00ed odm\u011bny a p\u0159ek\u00e1\u017eky a jejich vliv na zm\u011bnu chov\u00e1n\u00ed souvisej\u00edc\u00edho se zdrav\u00edm"},"content":{"rendered":"

Jean Adams, <\/em>Centre for Diet & Activity Research<\/em><\/a>, University of Cambridge<\/em><\/strong><\/p>\n

Od lo\u0148sk\u00e9ho \u0159\u00edjna si velk\u00e9 obchodn\u00ed \u0159et\u011bzce v\u00a0Anglii ze z\u00e1kona \u00fa\u010dtuj\u00ed 5 penc\u00ed (cca 2 K\u010d) za jednor\u00e1zov\u00e9 plastov\u00e9 ta\u0161ky<\/a> \u2013 ty tenk\u00e9 s\u00e1\u010dky, kter\u00e9 dostanete v supermarketech, abyste si mohli dom\u016f odn\u00e9st n\u00e1kup. Z\u00edskan\u00e9 pen\u00edze jsou obchodn\u00edky v\u011bnov\u00e1ny na \u201edobr\u00e9 \u00fa\u010dely\u201c. B\u011bhem prvn\u00edch \u0161esti m\u011bs\u00edc\u016f tohoto programu poklesl ve v\u00fdznamn\u00fdch supermarketech po\u010det prodan\u00fdch plastov\u00fdch ta\u0161ek o v\u00edce ne\u017e 90%<\/a> (to je o 7 miliard ta\u0161ek m\u00e9n\u011b!) a v\u00edce ne\u017e 29 milion\u016f liber (865 mil. K\u010d) se v\u011bnovalo na dobro\u010dinnost. Jen t\u011b\u017eko se z\u00a0toho d\u00e1 nevyvodit z\u00e1v\u011br, \u017ee i mal\u00e1 pen\u011b\u017en\u00ed p\u0159ek\u00e1\u017eka m\u016f\u017ee m\u00edt velk\u00fd vliv na na\u0161e chov\u00e1n\u00ed.<\/p>\n

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Mohou finan\u010dn\u00ed odm\u011bny v\u00e9st ke zm\u011bn\u011b chov\u00e1n\u00ed souvisej\u00edc\u00edho se zdrav\u00edm?<\/strong><\/p>\n

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Zkusme pou\u017e\u00edvat finan\u010dn\u00ed odm\u011bny a p\u0159ek\u00e1\u017eky, abychom zm\u011bnili zdravotn\u00ed chov\u00e1n\u00ed lid\u00ed. Tento n\u00e1pad se za\u010d\u00edn\u00e1 uj\u00edmat v\u00edce a v\u00edce. N\u011bkter\u00e9 zem\u011b St\u0159edn\u00ed a Ji\u017en\u00ed Ameriky zkou\u0161ej\u00ed zav\u00e1d\u011bt rozs\u00e1hl\u00e9 programy finan\u010dn\u00edch odm\u011bn<\/a> k motivaci matek, aby vyu\u017e\u00edvaly zdravotn\u00ed p\u00e9\u010de p\u0159ed porodem, nech\u00e1valy sv\u00e9 d\u011bti o\u010dkovat a pos\u00edlaly je do \u0161koly. Poka\u017ed\u00e9, kdy\u017e matka s n\u00e1rokem na tuto podporu doc\u00edl\u00ed programem vy\u017eadovan\u00e9ho chov\u00e1n\u00ed, z\u00edsk\u00e1 hotovost p\u0159\u00edmo od vl\u00e1dy. Existuj\u00ed povzbudiv\u00e9 d\u016fkazy<\/a>, \u017ee takov\u00e9to programy mohou pozitivn\u011b ovlivnit zdrav\u00ed d\u011bt\u00ed v\u00a0n\u00edzkop\u0159\u00edjmov\u00fdch i st\u0159edn\u011b p\u0159\u00edjmov\u00fdch zem\u00edch.<\/p>\n

Vysokop\u0159\u00edjmov\u00e9 zem\u011b jsou v p\u0159ej\u00edman\u00ed my\u0161lenky zav\u00e9st finan\u010dn\u00ed odm\u011bny a t\u00edm m\u011bnit zdravotn\u00ed chov\u00e1n\u00ed pomalej\u0161\u00ed. Informa\u010dn\u00ed z\u00e1kladna nicm\u00e9n\u011b roste a dva systematick\u00e9 p\u0159ehledy<\/a> literatury ji\u017e poukazuj\u00ed na to, \u017ee tyto programy mohou b\u00fdt efektivn\u00ed a jejich dopady mohou p\u0159etrvat i ur\u010ditou dobu po zastaven\u00ed odm\u011bn. O tom, \u017ee finan\u010dn\u00ed odm\u011bny podkop\u00e1vaj\u00ed vnit\u0159n\u00ed motivaci lid\u00ed chovat se zdrav\u011b, je d\u016fkaz\u016f jen m\u00e1lo<\/a>. Nav\u00edc se zd\u00e1, \u017ee odm\u011bny funguj\u00ed i u tzv. komplexn\u00edho chov\u00e1n\u00ed, nap\u0159. odvyk\u00e1n\u00ed kou\u0159en\u00ed<\/a>, kde ke zm\u011bn\u00e1m doch\u00e1z\u00ed t\u011b\u017eko.<\/p>\n

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Pro\u010d se finan\u010dn\u00ed odm\u011bny za zdrav\u00ed prosp\u011b\u0161n\u00e9 chov\u00e1n\u00ed pou\u017e\u00edvaj\u00ed v\u00a0praxi m\u00e1lo?<\/strong><\/p>\n

Zat\u00edmco finan\u010dn\u00ed odm\u011bny za zm\u011bnu zdravotn\u00edho chov\u00e1n\u00ed mohou fungovat v teorii, v praxi b\u00fdv\u00e1 jejich vyu\u017eit\u00ed vysoce problematick\u00e9. Aby se vyu\u017eil pln\u00fd potenci\u00e1l jak\u00e9koliv intervence, mus\u00ed b\u00fdt v\u0161ichni \u201enalad\u011bni\u201c na z\u00e1kladn\u00ed my\u0161lenku<\/a> \u2013 od z\u00e1konod\u00e1rc\u016f, kte\u0159\u00ed strategii navrhuj\u00ed, po pracovn\u00edky v\u00a0prvn\u00ed linii, kte\u0159\u00ed distribuuj\u00ed programy pro ve\u0159ejnost \u2013 a\u017e po ty, kte\u0159\u00ed jsou koncov\u00fdmi p\u0159\u00edjemci intervence.<\/p>\n

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Kdy\u017e se bav\u00edme s\u00a0lidmi<\/a> o nab\u00eddce finan\u010dn\u00edch odm\u011bn za odvyk\u00e1n\u00ed kou\u0159en\u00ed, pravidelnou fyzickou aktivitu, dostaven\u00ed se k\u00a0o\u010dkov\u00e1n\u00ed<\/a> nebo na pravideln\u00fd screening rakoviny, setk\u00e1v\u00e1me se sp\u00ed\u0161e s\u00a0negativn\u00edmi reakcemi. Obecn\u011b panuje souhlas s t\u00edm, \u017ee odm\u011bny mohou n\u011bkter\u00e9 lidi motivovat ke zdrav\u00ed prosp\u011b\u0161n\u011bj\u0161\u00edmu chov\u00e1n\u00ed. Ten na druhou stranu b\u00fdv\u00e1 p\u0159ev\u00e1\u017een siln\u011bj\u0161\u00edmi pocity, \u017ee odm\u011bny nejsou f\u00e9r k\u00a0lidem, kte\u0159\u00ed se chovaj\u00ed \u201espr\u00e1vn\u011b\u201c i bez nich. Tak\u00e9 panuje obava, \u017ee se lid\u00e9 budou sna\u017eit podv\u00e1d\u011bt a \u201eobch\u00e1zet\u201c tak syst\u00e9m lhan\u00edm o sv\u00e9m chov\u00e1n\u00ed tak, aby z\u00edskali odm\u011bnu, kterou si nezaslou\u017e\u00ed. Zd\u00e1 se, \u017ee dne\u0161n\u00ed finan\u010dn\u00ed klima je ovlivn\u011bno pocitem, \u017ee d\u00e1vat pen\u00edze prost\u011b nem\u016f\u017ee b\u00fdt z\u00a0hlediska n\u00e1klad\u016f efektivn\u00ed, a \u017ee si to dokonce nem\u016f\u017eeme dovolit, a tak by odm\u011bna m\u011bla m\u00edt n\u00edzkou hodnotu. Z\u00e1rove\u0148 panuje obava, \u017ee by p\u0159\u00edjemci mohli utratit sv\u00e9 odm\u011bny za zdrav\u00ed \u0161kodliv\u00e9 produkty. Z\u00e1konod\u00e1rci<\/a> se tak\u00e9 ob\u00e1vaj\u00ed, \u017ee odm\u011bny ne\u0159e\u0161\u00ed \u0161ir\u0161\u00ed spole\u010densk\u00e9 determinanty<\/a> zdrav\u00ed \u0161kodliv\u00e9ho chov\u00e1n\u00ed a \u017ee jsou tyto intervence t\u011b\u017eko obhajiteln\u00e9 p\u0159ed ostatn\u00edmi politiky a m\u00e9dii.<\/p>\n

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Ve v\u0161ech na\u0161ich kvalitativn\u00edch v\u00fdzkumech \u00fa\u010dastn\u00edci dychtiv\u011b navrhovali alternativn\u00ed mo\u017enosti zlep\u0161en\u00ed zdravotn\u00edho chov\u00e1n\u00ed \u2013 zejm\u00e9na prost\u0159ednictv\u00edm vzd\u011bl\u00e1v\u00e1n\u00ed a informov\u00e1n\u00ed, ani\u017e bychom to p\u0159\u00edmo vy\u017eadovali. Zd\u00e1 se, \u017ee nab\u00edzet finan\u010dn\u00ed odm\u011bnu prost\u011b v\u011bt\u0161in\u011b lid\u00ed nep\u0159ipad\u00e1 jako \u201esamoz\u0159ejm\u00e9\u201c \u0159e\u0161en\u00ed, naopak c\u00edt\u00ed, \u017ee by m\u011bly b\u00fdt nejprve vy\u010derp\u00e1ny ostatn\u00ed mo\u017enosti.<\/p>\n

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Zaj\u00edmav\u00e9 je, \u017ee pokud prov\u00e1d\u00edme v\u00fdzkum pomoc\u00ed on-line dotazn\u00edk\u016f, doch\u00e1z\u00edme ke zcela jin\u00fdm v\u00fdsledk\u016fm. Dvakr\u00e1t jsme zjistili, \u017ee lid\u00e9 pova\u017euj\u00ed programy na podporu zm\u011bny zdravotn\u00edho chov\u00e1n\u00ed, kter\u00e9 zahrnuj\u00ed finan\u010dn\u00ed odm\u011bny, za srovnateln\u00e9<\/a> nebo v\u00edce l\u00e1kav\u00e9<\/a> ne\u017e programy bez odm\u011bn. Mo\u017en\u00e1, \u017ee pokud jsou lid\u00e9 chr\u00e1n\u011bni anonymitou internetu, m\u00e9n\u011b se ost\u00fdchaj\u00ed vyj\u00e1d\u0159it sv\u00e9 tendence nechat se koupit. Samoz\u0159ejm\u011b, u diskuzn\u00edch skupin nebo rozhovor\u016f m\u016f\u017eeme o\u010dek\u00e1vat jist\u00e9 zkreslen\u00ed z\u00a0hlediska \u201esoci\u00e1ln\u00ed \u017e\u00e1doucnosti\u201c v tom, co lid\u00e9 pova\u017euj\u00ed za p\u0159ijateln\u00e9 o finan\u010dn\u00edch odm\u011bn\u00e1ch sd\u011blovat.<\/p>\n

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Na kultu\u0159e a kontextu, zd\u00e1 se, tak\u00e9 z\u00e1le\u017e\u00ed a prok\u00e1zalo se, \u017ee finan\u010dn\u00ed pob\u00eddky u chov\u00e1n\u00ed souvisej\u00edc\u00edho se zdrav\u00edm jsou p\u0159ijateln\u011bj\u0161\u00ed v\u00a0USA, ne\u017e ve Spojen\u00e9m kr\u00e1lovstv\u00ed \u2013 mo\u017en\u00e1 proto, \u017ee je v\u00a0Americe norm\u00e1ln\u011bj\u0161\u00ed spojovat pen\u00edze se zdravotn\u00ed p\u00e9\u010d\u00ed, ne\u017e je tomu v\u00a0Brit\u00e1nii (kde je syst\u00e9m zdravotn\u00ed p\u00e9\u010de st\u00e1tn\u00ed).<\/p>\n

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Doporu\u010den\u00ed pro praxi<\/strong><\/p>\n

Pen\u011b\u017en\u00ed odm\u011bny mohou b\u00fdt ur\u010dit\u011b efektivn\u00edm zp\u016fsobem, jak lidem pomoci zm\u011bnit zdravotn\u00ed chov\u00e1n\u00ed. Bohu\u017eel nejsou p\u0159ijateln\u00e9 bez v\u00fdjimky. Jak\u00fdkoliv program odm\u011bn by m\u011bl b\u00fdt zav\u00e1d\u011bn s\u00a0ohledem na obavy lid\u00ed. To m\u016f\u017ee obn\u00e1\u0161et:<\/p>\n

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