{"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\/lt\/2016\/12\/does-money-really-change-everything-using-financial-incentives-and-disincentives-to-change-health-behaviours\/","title":{"rendered":"Ar pinigai tikrai visk\u0105 pakei\u010dia? Kaip keisti sveikos gyvensenos \u012fpro\u010dius, naudojant finansines paskatas ir baudas?"},"content":{"rendered":"<p><strong><em>Jean Adams, <\/em><a href=\"http:\/\/www.cedar.iph.cam.ac.uk\/\"><em>Dietos ir veiklos tyrim\u0173 centras<\/em><\/a><em>, Kembrid\u017eo universitetas<\/em><\/strong><\/p>\n<p>Nuo pra\u0117jusi\u0173 met\u0173 spalio, \u012fsigaliojus \u012fstatymui, didieji Anglijos ma\u017emenininkai po 5 pensus (0,06 euro cent\u0173) apmokestino \u201e<a href=\"https:\/\/www.gov.uk\/government\/publications\/single-use-plastic-carrier-bags-why-were-introducing-the-charge\/carrier-bags-why-theres-a-5p-charge\">vienkartinius plastikinius mai\u0161elius<\/a><u>\u201c<\/u> \u2013 tuos paprastus plastikinius mai\u0161elius, naudojamus parsine\u0161ti pirkinius namo. Surinktus pinigus ma\u017emenininkai aukoja \u201ekilniems tikslams\u201c. Per pirmuosius \u0161e\u0161is m\u0117nesius nuo akcijos prad\u017eios, plastikini\u0173 mai\u0161eli\u0173 naudojimas did\u017eiuosiuose prekybos centruose suma\u017e\u0117jo <a href=\"https:\/\/www.gov.uk\/government\/publications\/carrier-bag-charge-summary-of-data-in-england-for-2015-to-2016\/single-use-plastic-carrier-bags-charge-data-in-england-for-2015-to-2016\">daugiau nei 90%<\/a> (tai 7 mlrd. ma\u017eiau mai\u0161eli\u0173!). Ir daugiau nei 29 mln. GBP (32mln. EUR) buvo paaukoti kilniems tikslams. Sunku nepadaryti i\u0161vados, kad ma\u017eos finansin\u0117s baudos gali tur\u0117ti didel\u012f poveik\u012f m\u016bs\u0173 elgesiui.<\/p>\n<p>&nbsp;<\/p>\n<p><!--more--><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Ar kei\u010diant sveikos gyvensenos \u012fpro\u010dius veikia finansin\u0117s paskatos?<\/strong><\/p>\n<p>Tai visgi, ar galima keisti \u017emoni\u0173 gyvensenos \u012fpro\u010dius naudojant finansines paskatas ir bausmes? \u0160ia id\u0117ja vis labiau domimasi. Kai kurios Centrin\u0117s ir Piet\u0173 Amerikos \u0161alys i\u0161band\u0117 <a href=\"https:\/\/en.wikipedia.org\/wiki\/Oportunidades\">dideles finansini\u0173 paskat\u0173 programas<\/a><u>,<\/u> siekiant paskatinti motinas lankytis n\u0117\u0161\u010di\u0173j\u0173 prie\u017ei\u016broje, skiepyti savo vaikus ir si\u0173sti juos \u012f mokykl\u0105. Kiekvien\u0105 kart\u0105, kriterijus atitinkan\u010dios motinos, \u012fvykd\u017eiusios programos elgesio reikalavimus, gauna i\u0161mok\u0105 grynaisiais pinigais tiesiogiai i\u0161 vyriausyb\u0117s . <a href=\"http:\/\/apps.who.int\/rhl\/effective_practice_and_organizing_care\/CD008137_huntingtond_com\/en\/\">\u012erodymai teikia vil\u010di\u0173<\/a>, kad \u0161ios programos gali tur\u0117ti teigiam\u0105 efekt\u0105 vaik\u0173 sveikatai \u017eemesni\u0173 ir vidutini\u0173 pajam\u0173 \u0161alyse.<\/p>\n<p>Auk\u0161tesni\u0173 pajam\u0173 \u0161alys l\u0117\u010diau per\u0117m\u0117 id\u0117j\u0105 naudoti finansines paskatas kei\u010diant gyvensen\u0105. Ta\u010diau \u012frodym\u0173 daug\u0117ja ir \u00a0<a href=\"http:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0090347\">dvi sistemin\u0117s<\/a> literat\u016bros ap\u017evalgos pateik\u0117 i\u0161vad\u0105, kad \u0161ios programos gali b\u016bti veiksmingos ir, kad poveikis gali trukti tam tikr\u0105 laik\u0105 ir po paskatos sustabdymo.\u00a0 Yra <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3906839\/\">ma\u017eai \u012frodym\u0173<\/a> kad finansin\u0117s paskatos pakenkt\u0173 \u201evidinei motyvacijai\u201c u\u017esiimti sveika gyvensena, ir pana\u0161u, kad paskatos veikia net ir tok\u012f vadinam\u0105 \u201esud\u0117tingu\u201c elges\u012f kaip <a href=\"http:\/\/www.bmj.com\/content\/350\/bmj.h134\">metimas r\u016bkyti<\/a>, kur\u012f yra sunku pakeisti.<\/p>\n<p><strong>Kod\u0117l finansin\u0117s paskatos gyvensenos keitimui n\u0117ra da\u017eniau naudojamos praktikoje?<\/strong><\/p>\n<p>Nors finansin\u0117s paskatos sveikai gyvensenai gali \u201eveikti\u201c teori\u0161kai, prakti\u0161kai gali b\u016bti gana problemi\u0161ka. Norint i\u0161naudoti vis\u0105 intervencijos potencial\u0105, <a href=\"http:\/\/journal.frontiersin.org\/article\/10.3389\/fpubh.2015.00200\/full\">turi b\u016bti \u012fsitrauk\u0119 visi<\/a> \u2013nuo politikos formuotoj\u0173 iki pristatymo program\u0173 darbuotoj\u0173, visuomen\u0117s ir t\u0173, kurie yra intervencijos tikslas.<\/p>\n<p>Kai <a href=\"http:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-015-1409-y\">kalb\u0117jome su \u017emon\u0117mis<\/a> apie si\u016blomas finansines paskatas mesti r\u016bkyti, prad\u0117ti reguliari\u0105 fizin\u0119 veikl\u0105, ar <a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0264410X16002991\">atvykti skiepytis<\/a> bei atlikti rutinines v\u0117\u017eio patikras, susid\u016br\u0117me su neigiama reakcija. Bendrai, yra sutinkama, kad paskatos gal\u0117t\u0173 pad\u0117ti kai kuriuos \u017emones \u012fsitraukti \u012f sveikesn\u012f elges\u012f, bet vis tik daugiau yra jau\u010dian\u010di\u0173 jog paskatos yra nes\u0105\u017eininga t\u0173 \u017emoni\u0173, kurie \u201eelgiasi teisingai\u201c be paskat\u0173, at\u017evilgiu. Taip pat nuog\u0105staujama, kad \u017emon\u0117s suk\u010diaus ir \u201eapgaus\u201c sistem\u0105 meluodami apie savo elges\u012f, su tikslu \u012fgyti atlyg\u012f, \u012f kur\u012f teis\u0117s jie neturi. \u0160iandien finansinis klimatas yra toks, kad manoma jog pinig\u0173 dalinimas niekaip negali b\u016bti laikomas efektyviomis i\u0161laidomis ar yra per brangu, manoma, kad bet koks paskatinimas tur\u0117t\u0173 b\u016bti ma\u017eos vert\u0117s. Taip pat jau\u010diamas nerimas, kad gav\u0117jai gali i\u0161leisti savo atlyg\u012f nesveikiems produktams. <a href=\"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-016-3646-0\">Politikos formuotojai<\/a> yra susir\u016bpin\u0119, kad paskatos nepadeda spr\u0119sti <a href=\"http:\/\/www.who.int\/social_determinants\/sdh_definition\/en\/\">platesni\u0173 socialini\u0173 veiksni\u0173<\/a><u>,<\/u> susijusi\u0173 su nesveika gyvensena, ir, kad \u0161ias intervencijas bus sunku pateisinti prie\u0161 politikus ir \u017einiasklaid\u0105.<\/p>\n<p>Visuose m\u016bs\u0173 kokybiniuose tyrimuose, dalyviai buvo pasiruo\u0161\u0119 pasi\u016blyti alternatyvius metodus, gerinant sveikatos elges\u012f, ypa\u010d per \u0161vietim\u0105 ir informacij\u0105. Mes niekada to tiesiogiai nesiek\u0117me. Pana\u0161u, kad finansin\u0117s paskatos si\u016blymas, daugeliui \u017emoni\u0173 n\u0117ra \u201eakivaizdus\u201c sprendimas ir jie jau\u010dia, kad pirmiau der\u0117t\u0173 i\u0161naudoti kitus b\u016bdus.<\/p>\n<p>\u012edomu, ta\u010diau gauname gana skirtingus rezultatus, kai atliekame apklausas internete. Du kartus nustat\u0117me, kad \u017emon\u0117s mano, jog gyvensenos keitimo programos, kurios numato finansines paskatas, yra <a href=\"http:\/\/journals.plos.org\/plosone\/article?id=10.1371%2Fjournal.pone.0157403\">tiek pat ar<\/a> <a href=\"http:\/\/www.journalslibrary.nihr.ac.uk\/hta\/volume-19\/issue-94\">labiau patrauklios<\/a><u>,<\/u> nei programos be paskat\u0173. Galb\u016bt, kai jau\u010diasi saug\u016bs d\u0117l interneto anonimi\u0161kumo, \u017emon\u0117s jau\u010diasi patogiau i\u0161reik\u0161dami savo gob\u0161umo tendencijas! \u017dinoma, mes galime tik\u0117tis, kad tikslin\u0117s grup\u0117s ar interviu metu, \u201esocialinio tikslingumo\u201c \u0161ali\u0161kumas \u0161iek tiek \u012ftakoja tai, k\u0105 \u017emon\u0117s laiko priimtina pasakyti apie finansines paskatas.<\/p>\n<p>Kult\u016bra ir kontekstas taip pat yra svarbu. Yra \u012frodym\u0173, kad finansin\u0117s paskatos gyvensenos keitimui yra labiau priimtinos JAV, nei Jungtin\u0117je Karalyst\u0117je &#8211; galb\u016bt tod\u0117l, kad JAV yra daugiau priimtina sieti pinigus su sveikata (r\u016bpyba) nei Jungtin\u0117je Karalyst\u0117je (kurioje veikia valstybin\u0117 sveikatos prie\u017ei\u016bros sistema).<\/p>\n<p><strong>Praktin\u0117s rekomendacijos<\/strong><\/p>\n<p>Finansin\u0117s paskatos tikrai gali b\u016bti veiksmingas b\u016bdas pad\u0117ti \u017emon\u0117ms keisti savo gyvensenos \u012fpro\u010dius. Ta\u010diau tai n\u0117ra visuotinai priimtina. Bet kuri skatinimo programa tur\u0117t\u0173 b\u016bti \u012fgyvendinama atkreipiant d\u0117mes\u012f \u012f \u017emoni\u0173 susir\u016bpinim\u0105 \u0161iomis programomis. Tai gali b\u016bti:<\/p>\n<ul>\n<li>Si\u016blyti ma\u017eesn\u0117s vert\u0117s paskatas, kad suma\u017e\u0117t\u0173 susir\u016bpinimas d\u0117l \u201em\u0117tom\u0173\u201c pinig\u0173.<\/li>\n<li>Si\u016blyti ne grynus pinigus, o dovan\u0173 \u010dekius, kad suma\u017e\u0117t\u0173 galimyb\u0117s panaudoti atlyg\u012f i\u0161leisti nesveikiems produktams.<\/li>\n<li>U\u017etikrinti, kad programos yra gerai pri\u017ei\u016brimos ir \u017emon\u0117s negali \u201eapgauti\u201c sistemos.<\/li>\n<li>\u012etraukti paskatas \u012f didesnes intervencij\u0173 programas, kuriose taip pat vykdomas \u0161vietimas bei informavimas apie sveik\u0105 gyvensen\u0105<\/li>\n<\/ul>\n<p>Taip pat, gali b\u016bti naudinga prad\u0117ti atviras ir s\u0105\u017einingas diskusijas bendruomen\u0117je, siekiant i\u0161siai\u0161kinti kada, kur ir kaip finansini\u0173 paskat\u0173 intervencijos laikomas tinkamiausiomis.<\/p>\n<p>&nbsp;<\/p>\n<p>Vertimas: Milda Go\u0161tautait\u0117, Antanas Go\u0161tautas<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dr Jean Adams,\u00a0Centre for Diet &amp; Activity Research, University of Cambridge Since October last year, by law, large retailers in England have been charging customers 5p (\u20ac0.06) for \u2018single-use plastic carrier bags\u2019 \u2013 those flimsy plastic bags you get from [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":236,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[8,7],"tags":[],"class_list":["post-222","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-financial-incentives","category-incentives"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"lt","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","fi","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":true,"content":true,"excerpt":false},"my":{"title":false,"content":false,"excerpt":false},"bg":{"title":true,"content":true,"excerpt":false},"zh":{"title":true,"content":true,"excerpt":false},"hr":{"title":false,"content":false,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":true,"content":true,"excerpt":false},"de":{"title":true,"content":true,"excerpt":false},"es":{"title":false,"content":false,"excerpt":false},"fr":{"title":true,"content":true,"excerpt":false},"gr":{"title":true,"content":true,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":false,"content":false,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":true,"content":true,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":false,"content":false,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":true,"content":true,"excerpt":false},"ro":{"title":true,"content":true,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":false,"content":false,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/posts\/222","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/comments?post=222"}],"version-history":[{"count":29,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/posts\/222\/revisions"}],"predecessor-version":[{"id":4652,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/posts\/222\/revisions\/4652"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/media\/236"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/media?parent=222"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/categories?post=222"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/tags?post=222"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}