Theresa Marteau, University of Cambridge, UK<\/p>\n\n\n\n
Mnoz\u00ed z n\u00e1s maj\u00ed pot\u00ed\u017ee j\u00edst zdrav\u011bji, omezit konzumaci alkoholu, p\u0159estat kou\u0159it nebo zvolit ch\u016fzi nam\u00edsto j\u00edzdy autem. A to i p\u0159esto, \u017ee v\u00edme, \u017ee by tyto zm\u011bny prosp\u011bly na\u0161emu zdrav\u00ed i \u017eivotn\u00edmu prost\u0159ed\u00ed. T\u00fdk\u00e1 se to nejen lid\u00ed, kter\u00fdm se sna\u017e\u00edme pom\u00e1hat, ale tak\u00e9 n\u00e1s samotn\u00fdch \u2013 psycholog\u016f a behavior\u00e1ln\u00edch v\u011bdc\u016f.<\/p>\n\n\n\n
Tento z\u00e1pas nen\u00ed selh\u00e1n\u00edm v\u016fle. Probl\u00e9m spo\u010d\u00edv\u00e1 sp\u00ed\u0161e v tom, \u017ee systematicky podce\u0148ujeme, nakolik na\u0161e ka\u017edodenn\u00ed prost\u0159ed\u00ed formuje na\u0161e chov\u00e1n\u00ed, a z\u00e1rove\u0148 p\u0159ece\u0148ujeme s\u00edlu vlastn\u00edch hodnot a z\u00e1m\u011br\u016f.<\/p>\n\n\n\n
Pro\u010d samotn\u00e9 v\u011bd\u011bn\u00ed nesta\u010d\u00ed<\/strong><\/p>\n\n\n\n Zva\u017eme nap\u0159\u00edklad personalizovan\u00e9 predikce zdravotn\u00edho rizika. Mohlo by se zd\u00e1t, \u017ee sd\u011blen\u00ed konkr\u00e9tn\u00ed pravd\u011bpodobnosti rozvoje diabetu 2. typu nebo kardiovaskul\u00e1rn\u00edho onemocn\u011bn\u00ed bude silnou motivac\u00ed ke zm\u011bn\u011b. Empirick\u00e9 d\u016fkazy v\u0161ak nazna\u010duj\u00ed opak. P\u011bt systematick\u00fdch p\u0159ehled\u016f zahrnuj\u00edc\u00edch des\u00edtky randomizovan\u00fdch kontrolovan\u00fdch studi\u00ed ukazuje, \u017ee poskytov\u00e1n\u00ed personalizovan\u00fdch odhad\u016f rizika \u2013 v\u010detn\u011b genetick\u00fdch rizikov\u00fdch sk\u00f3re<\/a> \u2013 m\u00e1 mal\u00fd nebo \u017e\u00e1dn\u00fd vliv na chov\u00e1n\u00ed lid\u00ed. M\u00edra fyzick\u00e9 aktivity, kou\u0159en\u00ed, konzumace alkoholu a nezdrav\u00e9ho stravov\u00e1n\u00ed z\u016fst\u00e1v\u00e1 nezm\u011bn\u011bna.<\/p>\n\n\n\n Podobn\u011b i klimatologov\u00e9 <\/a>disponuj\u00ed detailn\u00edmi znalostmi o zm\u011bn\u011b klimatu, p\u0159esto \u010dasto l\u00e9taj\u00ed stejn\u011b \u010dasto jako ostatn\u00ed akademici. Samotn\u00e9 znalosti jen z\u0159\u00eddka vedou k dlouhodob\u00e9 zm\u011bn\u011b chov\u00e1n\u00ed.<\/a><\/p>\n\n\n\n Je to prost\u0159ed\u00ed<\/strong><\/p>\n\n\n\n Vysv\u011btlen\u00ed nab\u00edz\u00ed du\u00e1ln\u00ed procesn\u00ed modely <\/a>(dual process models<\/em>) z oblasti behavior\u00e1ln\u00edch v\u011bd. Na\u0161e chov\u00e1n\u00ed je regulov\u00e1no dv\u011bma vz\u00e1jemn\u011b se ovliv\u0148uj\u00edc\u00edmi syst\u00e9my. Prvn\u00ed syst\u00e9m je pomal\u00fd, reflektivn\u00ed a c\u00edlov\u011b orientovan\u00fd. Vyu\u017e\u00edv\u00e1me jej p\u0159i \u010dten\u00ed, osvojov\u00e1n\u00ed nov\u00fdch dovednost\u00ed nebo p\u0159i odol\u00e1v\u00e1n\u00ed poku\u0161en\u00ed. Druh\u00fd syst\u00e9m je rychl\u00fd, automatick\u00fd a \u0159\u00edzen\u00fd podn\u011bty z prost\u0159ed\u00ed, kdy\u017e vid\u00edme kol\u00e1\u010d, vezmeme si ho. Pokud je na\u0161e omezen\u00e1 reflektivn\u00ed kapacita pln\u011b vyt\u00ed\u017eena, automatick\u00fd syst\u00e9m reaguje p\u0159\u00edmo na environment\u00e1ln\u00ed podn\u011bty.<\/a> Pr\u00e1v\u011b proto b\u00fdv\u00e1 zm\u011bna podn\u011bt\u016f v na\u0161em okol\u00ed \u00fa\u010dinn\u011bj\u0161\u00ed ne\u017e snaha m\u011bnit pouze to, co se odehr\u00e1v\u00e1 v na\u0161\u00ed hlav\u011b.<\/p>\n\n\n\n Nejsiln\u011bj\u0161\u00ed environment\u00e1ln\u00ed podn\u011bty lze shrnout do tzv. \u201e3A\u201c: Affordability, Availability a Appeal<\/strong>. Tedy do faktor\u016f dostupnosti z hlediska ceny (cenov\u00e1 dosa\u017eitelnost), fyzick\u00e9 dostupnosti a p\u0159ita\u017elivosti.<\/p>\n\n\n\n Affordability: Cena ovliv\u0148uje chov\u00e1n\u00ed<\/strong><\/p>\n\n\n\n Zvy\u0161ov\u00e1n\u00ed cen tab\u00e1kov\u00fdch v\u00fdrobk\u016f p\u0159edstavuje nej\u00fa\u010dinn\u011bj\u0161\u00ed politick\u00e9 opat\u0159en\u00ed ke sn\u00ed\u017een\u00ed prevalence kou\u0159en\u00ed. Zv\u00fd\u0161en\u00ed ceny o 10 % vede p\u0159ibli\u017en\u011b ke 4% poklesu spot\u0159eby tab\u00e1ku<\/a>. Zdan\u011bn\u00ed slazen\u00fdch limon\u00e1d <\/a>sni\u017euje jejich konzumaci. Naopak spot\u0159eba ovoce a zeleniny roste v p\u0159\u00edpad\u011b, \u017ee jsou jejich ceny sn\u00ed\u017eeny prost\u0159ednictv\u00edm dotac\u00ed<\/a>.<\/p>\n\n\n\n Dostupnost: Vyb\u00edr\u00e1 se to, co je dostupn\u00e9<\/strong><\/p>\n\n\n\n V r\u00e1mci studie, do kter\u00e9 se zapojilo 20 000 zam\u011bstnanc\u016f z 19 podnikov\u00fdch j\u00eddelen, m\u016fj v\u00fdzkumn\u00fd t\u00fdm zv\u00fd\u0161il pod\u00edl nab\u00edzen\u00fdch n\u00edzkokalorick\u00fdch ob\u011bd\u016f a sn\u00ed\u017eil velikost porc\u00ed kaloricky bohat\u0161\u00edch j\u00eddel. V\u00fdsledek? Zam\u011bstnanci nakoupili o 11,5 % m\u00e9n\u011b kalori\u00ed,<\/a> proto\u017ee se jim usnadnil v\u00fdb\u011br zdrav\u011bj\u0161\u00edch variant.<\/p>\n\n\n\n V\u00fdzva: Reklama funguje<\/strong><\/p>\n\n\n\n Z\u00e1kaz reklamy a sponzorstv\u00ed ze strany tab\u00e1kov\u00e9ho,<\/a> alkoholov\u00e9ho<\/a> a potravin\u00e1\u0159sk\u00e9ho pr\u016fmyslu (v oblasti nezdrav\u00fdch potravin<\/a>) sni\u017euje p\u0159ita\u017elivost jejich produkt\u016f i jejich n\u00e1kup. Podobn\u00e9 efekty lze o\u010dek\u00e1vat tak\u00e9 u produkt\u016f z oblasti fosiln\u00edch paliv.<\/a> Zv\u00fd\u0161en\u00ed viditelnosti varovn\u00fdch sd\u011blen\u00ed a odstran\u011bn\u00ed zna\u010dkov\u00e9ho designu z obal\u016f rovn\u011b\u017e sni\u017euje atraktivitu t\u011bchto v\u00fdrobk\u016f. Nap\u0159\u00edklad varovn\u00e9 etikety na alkoholick\u00fdch n\u00e1poj\u00edch v kanadsk\u00e9m teritoriu Yukon, kter\u00e9 explicitn\u011b upozor\u0148ovaly na riziko vzniku rakoviny v souvislosti s konzumac\u00ed alkoholu, vedly p\u0159ibli\u017en\u011b k 6% poklesu prodeje alkoholu<\/a>. Standardizovan\u00e9 (\u201eplain\u201c) balen\u00ed tab\u00e1kov\u00fdch v\u00fdrobk\u016f nav\u00edc zvy\u0161uje viditelnost zdravotn\u00edch varov\u00e1n\u00ed, a t\u00edm d\u00e1le oslabuje p\u0159ita\u017elivost zna\u010dky.<\/a><\/p>\n\n\n\n Pro\u010d je regulace d\u016fle\u017eit\u00e1<\/strong><\/p>\n\n\n\n V\u011bt\u0161ina intervenc\u00ed, kter\u00e9 m\u011bn\u00ed podn\u011bty v na\u0161em ka\u017edodenn\u00edm prost\u0159ed\u00ed s c\u00edlem ovlivnit chov\u00e1n\u00ed, vy\u017eaduje regula\u010dn\u00ed opat\u0159en\u00ed<\/a>, pr\u00e1v\u011b proto, \u017ee jsou v rozporu s komer\u010dn\u00edmi z\u00e1jmy. \u010cty\u0159i pr\u016fmyslov\u00e1 odv\u011btv\u00ed \u2013 tab\u00e1kov\u00fd, alkoholov\u00fd, pr\u016fmysl nezdrav\u00fdch potravin a fosiln\u00edch paliv \u2013 produkuj\u00ed v\u00fdrobky, kter\u00e9 se pod\u00edlej\u00ed nejm\u00e9n\u011b na jednom ze \u010dty\u0159 \u00famrt\u00ed celosv\u011btov\u011b<\/a> a sou\u010dasn\u011b stoj\u00ed za v\u011bt\u0161inou emis\u00ed sklen\u00edkov\u00fdch plyn\u016f <\/a>p\u0159isp\u00edvaj\u00edc\u00edch k oteplov\u00e1n\u00ed klimatu.<\/p>\n\n\n\n P\u0159esto nad\u00e1le p\u0159eva\u017euj\u00ed informa\u010dn\u00ed kampan\u011b a dobrovoln\u00e1 seberegulace ze strany pr\u016fmyslu jako preferovan\u00e9 p\u0159\u00edstupy. Tato odv\u011btv\u00ed tuto preferenci aktivn\u011b podporuj\u00ed, prost\u0159ednictv\u00edm lobbingu, financov\u00e1n\u00ed v\u00fdzkumu, kter\u00fd zpochyb\u0148uje \u00fa\u010dinnost regula\u010dn\u00edch opat\u0159en\u00ed, a r\u00e1mov\u00e1n\u00ed vl\u00e1dn\u00edch intervenc\u00ed jako omezen\u00ed osobn\u00ed svobody.<\/p>\n\n\n\n Co se pot\u0159ebuje zm\u011bnit<\/strong><\/p>\n\n\n\n Pot\u0159ebujeme chr\u00e1nit v\u011bdeck\u00e9 poznatky i tvorbu ve\u0159ejn\u00fdch politik p\u0159ed korpor\u00e1tn\u00edm zasahov\u00e1n\u00edm. Oblast kontroly tab\u00e1ku zde nab\u00edz\u00ed inspirativn\u00ed model. \u200b\u200bZem\u011b, kter\u00e9 p\u0159ijaly \u010dl\u00e1nek 5.3 mezin\u00e1rodn\u00ed smlouvy<\/a> o kontrole tab\u00e1ku, chr\u00e1nily tvorbu politik p\u0159ed zasahov\u00e1n\u00edm pr\u016fmyslu, zavedly politiky zalo\u017een\u00e9 v\u00edce na d\u016fkazech a maj\u00ed ni\u017e\u0161\u00ed m\u00edru kou\u0159en\u00ed. Tuto ochranu je nezbytn\u00e9 roz\u0161\u00ed\u0159it na v\u0161echny korporace produkuj\u00edc\u00ed v\u00fdrobky, kter\u00e9 po\u0161kozuj\u00ed na\u0161e zdrav\u00ed a devastuj\u00ed na\u0161i planetu. Ob\u010dansk\u00e1 shrom\u00e1\u017ed\u011bn\u00ed<\/a> a dal\u0161\u00ed formy deliberativn\u00ed demokracie, v nich\u017e ob\u010dan\u00e9 spolupracuj\u00ed s m\u00edstn\u00edmi \u010di n\u00e1rodn\u00edmi vl\u00e1dami, se z\u00e1rove\u0148 jev\u00ed jako velmi perspektivn\u00ed n\u00e1stroje. Posiluj\u00ed jak vliv ob\u010dan\u016f na tvorbu ve\u0159ejn\u00fdch politik, tak i roli v\u011bdeck\u00fdch d\u016fkaz\u016f v rozhodovac\u00edch procesech.<\/p>\n\n\n\n Praktick\u00e1 doporu\u010den\u00ed<\/strong><\/p>\n\n\n\n Pro zdravotn\u00edky<\/strong><\/p>\n\n\n\n Pro t\u00fdmy ve\u0159ejn\u00e9ho zdrav\u00ed<\/strong><\/p>\n\n\n\n Translated by: Krist\u00fdna Anna \u010cern\u00edkov\u00e1<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":" By Theresa Marteau, University of Cambridge, UK Many of us struggle to eat more healthily, drink less alcohol, quit smoking, or walk instead of driving. This is true even when we know these changes would benefit our health and the […]<\/p>\n","protected":false},"author":9,"featured_media":4797,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"By Theresa Marteau, University of Cambridge, UK<\/strong>\n\nMany of us struggle to eat more healthily, drink less alcohol, quit smoking, or walk instead of driving. This is true even when we know these changes would benefit our health and the planet. It applies to psychologists and behavioural scientists as well as the people we're trying to help.\n\n\n\nThis struggle isn't a failure of willpower. The problem is we consistently underestimate how much our everyday environments shape our behaviour, and overestimate the power of our values and intentions.\n\nWhy knowing isn't enough<\/strong>\n\nConsider personalised health predictions. Surely telling someone their exact risk of developing type 2 diabetes or heart disease would motivate change? The evidence says otherwise. Five systematic reviews including dozens of randomised controlled trials show that giving people personalised risk estimates\u2014including genetic risk scores<\/a>\u2014has little or no impact on their behaviour. Rates of physical activity, smoking, alcohol consumption, and unhealthy eating remain unchanged.\n\nSimilarly, climate scientists<\/a> possess detailed knowledge about climate change yet often fly as much as other academics. Knowledge alone rarely drives sustained behaviour change.<\/a>\n\nIt\u2019s the environment<\/strong>\n\nDual Process Models<\/a> from behavioural science help explain this. Our behaviour is regulated by two interacting systems. One is slow, reflective, and goal-directed. We use it to read, learn new skills, and resist temptation. The other is fast, automatic, and cue-driven\u2014when we see cake, we take it. When our limited reflective capacity is fully occupied, our automatic system responds directly to environmental cues<\/a>. This is why changing the cues around us is more powerful than trying to change what's in our heads.\n\nThe most powerful environmental cues fall under the 3 As: Affordability, Availability, and Appeal.\n\nAffordability: Price changes behaviour<\/strong>\n\nIncreasing tobacco prices is the single most effective policy to reduce smoking. A 10% price increase reduces tobacco use<\/a> by around 4 %. Soda taxes<\/a> reduce consumption of sugary drinks. Fruit and vegetable consumption increases with subsidies<\/a> to lower their price.\n\nAvailability: What's accessible gets chosen<\/strong>\n\nIn a study with 20,000 employees across 19 workplace cafeterias, my research team increased the proportion of lower-calorie lunches offered and reduced portion sizes of higher-calorie meals. The result? Employees purchased 11.5% fewer calories<\/a> as healthier options became easier to choose.\n\nAppeal: Advertising works<\/strong>\n\nStopping advertising and sponsorships by the tobacco<\/a>, alcohol<\/a>, unhealthy food<\/a> industries reduces the appeal and purchasing of their products. Similar effects are expected for fossil fuel<\/a> products. Adding clear warning labels and removing branding from products also reduces their appeal. Labels on alcohol in Yukon, Canada, clearly warning of cancer from drinking, reduced alcohol sales<\/a> by around 6 %. Plain packaging of tobacco renders warning labels more visible<\/a>.\n\nWhy regulation matters<\/strong>\n\nMost interventions that alter cues in our everyday environments to change behaviour require regulation<\/a> because they conflict with commercial interests. Four industries\u2014tobacco, alcohol, unhealthy food, and fossil fuels\u2014generate products that cause at least one in four deaths globally<\/a> each year, and the majority of greenhouse gas emissions<\/a> warming the climate.\n\nYet information campaigns and voluntary industry self-regulation remain the favoured approaches. These industries actively promote this preference through lobbying, funding research that questions regulation, and framing government intervention as restricting freedom.\n\nWhat needs to change<\/strong>\n\nWe need to shield evidence and policymaking from corporate interference. Tobacco control provides a model. Countries that have adopted Article 5.3 from the international treaty<\/a> on tobacco control protected policymaking from industry interference, implemented more evidence-based policies, and have the lower rates of smoking. We need to extend this protection to cover all corporations generating products that ruin our health and wreck our planet. Citizen Assemblies<\/a> and other forms of deliberative democracy in which citizens work collaboratively with our local or national governments also show much promise both in increasing citizens influence on policymaking and the influence of evidence.\n\nPractical Recommendations<\/strong>\n\nFor healthcare practitioners<\/strong>\n\n
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