Theresa Marteau, Sveu\u010dili\u0161te u Cambridgeu, UK<\/p>\n\n\n\n
Mnogi od nas imaju pote\u0161ko\u0107a s time da se zdravije hrane, piju manje alkohola, prestanu pu\u0161iti ili hodaju umjesto da se voze. To vrijedi \u010dak i kada znamo da bi te promjene koristile na\u0161em zdravlju i planetu. To se odnosi na psihologe i bihevioralne znanstvenike jednako kao i na ljude kojima poku\u0161avamo pomo\u0107i.<\/p>\n\n\n\n
Ova borba nije neuspjeh snage volje. Problem je u tome \u0161to sustavno podcjenjujemo koliko na\u0161e svakodnevno okru\u017eenje oblikuje na\u0161e pona\u0161anje, a precjenjujemo snagu svojih vrijednosti i namjera.<\/p>\n\n\n\n
Razmotrimo personalizirana zdravstvena predvi\u0111anja. Sigurno bi nekoga motiviralo kada bi mu se reklo koliki je njegov to\u010dan rizik od razvoja dijabetesa tipa 2 ili bolesti srca? Dokazi govore suprotno. Pet sustavnih pregleda koji uklju\u010duju desetke randomiziranih kontroliranih ispitivanja pokazuju da davanje personaliziranih procjena rizika ljudima \u2013 uklju\u010duju\u0107i rezultate genetskog rizika<\/a> – ima mali ili nikakav utjecaj na pona\u0161anje. Stope tjelesne aktivnosti, pu\u0161enja, konzumacije alkohola i nezdrave prehrane ostaju nepromijenjene.<\/p>\n\n\n\n Sli\u010dno tome, klimatolozi<\/a> imaju detaljno znanje o klimatskim promjenama, ali \u010desto lete avionom jednako kao i drugi akademici. Samo znanje rijetko dovodi do trajne promjene pona\u0161anja<\/a>.<\/p>\n\n\n\n Modeli dvostrukog procesa (engl. Dual Process Models<\/a>) iz bihevioralne znanosti poma\u017eu to objasniti. Na\u0161e pona\u0161anje reguliraju dva me\u0111usobno povezana sustava. Jedan je spor, refleksivan i usmjeren na ciljeve. Njega koristimo za \u010ditanje, u\u010denje novih vje\u0161tina i odupiranje isku\u0161enjima. Drugi je brz, automatski i vo\u0111en podra\u017eajima \u2013 kad vidimo kola\u010d, uzmemo ga. Kada je na\u0161 ograni\u010deni refleksivni kapacitet potpuno zauzet, na\u0161 automatski sustav reagira izravno na podra\u017eaje iz okoline<\/a>. Zato je mijenjanje podra\u017eaja oko nas sna\u017enije od poku\u0161aja da promijenimo ono \u0161to je u na\u0161im mislima.<\/p>\n\n\n\n Najsna\u017eniji okoli\u0161ni podra\u017eaji mogu se svesti na tri A: pristupa\u010dnost (engl. Affordability), dostupnost (engl. Availability) i privla\u010dnost (engl. Appeal).<\/p>\n\n\n\n Pove\u0107anje cijena duhanskih proizvoda naju\u010dinkovitija je mjera za smanjenje pu\u0161enja. Pove\u0107anje cijene od 10 % smanjuje konzumaciju duhana<\/a> za oko 4 %. Porezi na sokove<\/a> smanjuju potro\u0161nju zasla\u0111enih pi\u0107a. Konzumacija vo\u0107a i povr\u0107a raste kada se subvencijama<\/a> snizi njihova cijena.<\/p>\n\n\n\n U istra\u017eivanju s 20.000 zaposlenika u 19 radnih menzi, moj istra\u017eiva\u010dki tim pove\u0107ao je udio ponu\u0111enih obroka s manje kalorija i smanjio veli\u010dine porcija visokokalori\u010dnih jela. Rezultat? Zaposlenici su kupovali 11.5 % manje kalorija<\/a> jer su zdravije opcije postale lak\u0161e za odabrati.<\/p>\n\n\n\n Zabrana ogla\u0161avanja i sponzorstva duhanske<\/a>, alkoholne<\/a> i industrije nezdrave hrane<\/a> smanjuje privla\u010dnost i kupnju njihovih proizvoda. Sli\u010dni u\u010dinci o\u010dekuju se i za proizvode od fosilnih goriva<\/a>. Dodavanje jasnih upozorenja i uklanjanje brendiranja tako\u0111er smanjuje privla\u010dnost proizvoda. Oznake na alkoholu u Yukonu u Kanadi, koje jasno upozoravaju na rizik od raka zbog konzumacije, smanjile su prodaju alkohola<\/a> za oko 6 %. Neutralno pakiranje duhanskih proizvoda \u010dini upozorenja vidljivijima<\/a>.<\/p>\n\n\n\n Ve\u0107ina intervencija koje mijenjaju podra\u017eaje u na\u0161em svakodnevnom okru\u017eenju kako bi promijenili pona\u0161anje zahtijeva regulaciju<\/a> jer su u sukobu s komercijalnim interesima. \u010cetiri industrije \u2013 duhan, alkohol, nezdrava hrana i fosilna goriva \u2013 generiraju proizvode koji uzrokuju najmanje jednu od \u010detiri smrti u svijetu svake godine<\/a>, kao i ve\u0107inu emisija stakleni\u010dkih plinova<\/a> koje zagrijavaju klimu.<\/p>\n\n\n\n Ipak, informativne kampanje i dobrovoljna samoregulacija industrije i dalje su preferirani pristupi. Te industrije aktivno promi\u010du takav pristup kroz lobiranje, financiranje istra\u017eivanja koja dovode u pitanje regulaciju i prikazivanje dr\u017eavnih intervencija kao ograni\u010davanja slobode.<\/p>\n\n\n\n Potrebno je za\u0161tititi znanstvene dokaze i dono\u0161enje politika od korporativnog utjecaja. Kontrola duhana pru\u017ea dobar model. Zemlje koje su usvojile \u010clanak 5.3 me\u0111unarodnog ugovora<\/a> o kontroli duhana za\u0161titile su proces dono\u0161enja politika od utjecaja industrije, provele vi\u0161e politika temeljenih na dokazima i imaju ni\u017ee stope pu\u0161enja. Takvu za\u0161titu treba pro\u0161iriti na sve korporacije koje stvaraju proizvode \u0161tetne za na\u0161e zdravlje i planet. Gra\u0111anske skup\u0161tine<\/a> i drugi oblici deliberativne demokracije, u kojima gra\u0111ani sura\u0111uju s lokalnim ili nacionalnim vlastima, tako\u0111er pokazuju velik potencijal u pove\u0107anju utjecaja gra\u0111ana na dono\u0161enje politika i utjecaja znanstvenih dokaza.<\/p>\n\n\n\n Prevele: <\/strong>Ivana Ivan\u010di\u0107, Vivien Gudlin<\/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>\nOkru\u017eenje je klju\u010dno<\/strong><\/h3>\n\n\n\n
Pristupa\u010dnost: cijena mijenja pona\u0161anje<\/strong><\/h3>\n\n\n\n
Dostupnost: biramo ono \u0161to je lako dostupno<\/strong><\/h3>\n\n\n\n
Privla\u010dnost: ogla\u0161avanje djeluje<\/strong><\/h3>\n\n\n\n
Za\u0161to je regulacija va\u017ena<\/strong><\/h3>\n\n\n\n
\u0160to se treba promijeniti<\/strong><\/h3>\n\n\n\n
Prakti\u010dne preporuke<\/strong><\/h3>\n\n\n\n
Za zdravstvene djelatnike<\/em><\/strong><\/h4>\n\n\n\n
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Za timove javnog zdravstva<\/em><\/strong><\/h4>\n\n\n\n
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