{"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\/sk\/2016\/12\/does-money-really-change-everything-using-financial-incentives-and-disincentives-to-change-health-behaviours\/","title":{"rendered":"Dok\u00e1\u017eu peniaze skuto\u010dne v\u0161etko zmeni\u0165? Pou\u017eitie pozit\u00edvnych a negat\u00edvnych finan\u010dn\u00fdch stimulov k zmene spr\u00e1vania v oblasti zdravia"},"content":{"rendered":"<p><strong><em>Jean Adams, <\/em><a href=\"http:\/\/www.cedar.iph.cam.ac.uk\/\"><em>Centre for Diet &amp; Activity Research<\/em><\/a><em>, University of Cambridge<\/em><\/strong><\/p>\n<p>Od okt\u00f3bra minul\u00e9ho roka musia pod\u013ea z\u00e1kona ve\u013ekopredajcovia v Anglicku \u00fa\u010dtova\u0165 svojim z\u00e1kazn\u00edkom 5 penc\u00ed (\u20ac 0,06) za &#8220;jednorazov\u00e9 plastov\u00e9 n\u00e1kupn\u00e9 ta\u0161ky&#8221; &#8211; tie nekvalitn\u00e9 plastov\u00e9 ta\u0161ky, \u00a0ktor\u00e9 dostanete v supermarkete, aby ste mohli odnies\u0165 svoje potraviny domov. Z\u00edskan\u00e9 peniaze ve\u013ekopredajcovia daruj\u00fa na &#8220;verejnoprospe\u0161n\u00e9 \u00fa\u010dely&#8221;. V prv\u00fdch \u0161iestich mesiacoch od zavedenia tohto syst\u00e9mu sa pou\u017eitie plastov\u00fdch ta\u0161iek ve\u013ek\u00fdmi supermarketmi zn\u00ed\u017eilo o viac ako 90% (\u010do je o 7 mili\u00e1rd plastov\u00fdch ta\u0161iek menej!) a viac ako\u00a0 29 mili\u00f3nov libier (32 mili\u00f3nov \u20ac) bolo venovan\u00fdch na verejnoprospe\u0161n\u00e9 \u00fa\u010dely. Je preto \u013eahk\u00e9 dospie\u0165 k z\u00e1veru, \u017ee i mal\u00e9 finan\u010dn\u00e9 stimuly m\u00f4\u017ee ma\u0165 ve\u013ek\u00fd vplyv na na\u0161e spr\u00e1vanie.<\/p>\n<p><!--more--><\/p>\n<p><strong>Funguj\u00fa finan\u010dn\u00e9 stimuly pri zmene so zdrav\u00edm s\u00favisiaceho spr\u00e1vania?<\/strong><\/p>\n<p>Pre\u010do teda nevyu\u017ei\u0165 finan\u010dn\u00e9 stimuly na zmenu so zdrav\u00edm s\u00favisiaceho spr\u00e1vanie sa \u013eud\u00ed? T\u00e1to my\u0161lienka sa v\u00a0s\u00fa\u010dasnosti st\u00e1va ve\u013emi chyt\u013eavou. Niektor\u00e9 krajiny v Strednej a Ju\u017enej Amerike sk\u00fa\u0161aj\u00fa ve\u013ek\u00e9 finan\u010dn\u00e9 motiva\u010dn\u00e9 programy s\u00a0cie\u013eom povzbudi\u0165 matky, aby sa z\u00fa\u010dastnili predp\u00f4rodnej starostlivosti, dali zao\u010dkova\u0165 svoje deti a posielali ich do \u0161koly. Zaka\u017ed\u00fdm, ke\u010f matky dosiahnu niektor\u00e9 z\u00a0pod\u013ea programu po\u017eadovan\u00fdch foriem spr\u00e1vania, dostan\u00fa platbu v hotovosti priamo od vl\u00e1dy. Existuj\u00fa povzbudzuj\u00face d\u00f4kazy, \u017ee tieto programy m\u00f4\u017eu ma\u0165 pozit\u00edvny vplyv na zdravie det\u00ed v krajin\u00e1ch s n\u00edzkymi a stredn\u00fdmi pr\u00edjmami.<\/p>\n<p>&nbsp;<\/p>\n<p>Krajiny s vy\u0161\u0161\u00edmi pr\u00edjmami s\u00fa pomal\u0161ie v prij\u00edman\u00ed my\u0161lienky finan\u010dn\u00fdch stimulov za \u00fa\u010delom zmeny so zdrav\u00edm s\u00favisiaceho spr\u00e1vania. D\u00f4kazy v\u0161ak neust\u00e1le prib\u00fadaj\u00fa a dva systematick\u00e9 preh\u013eady literat\u00fary dospeli k z\u00e1veru, \u017ee tieto programy m\u00f4\u017eu by\u0165 \u00fa\u010dinn\u00e9, a \u017ee \u00fa\u010dinky m\u00f4\u017eu trva\u0165 aj nejak\u00fa dobu potom, \u010do boli stimuly zastaven\u00e9. Existuje len m\u00e1lo d\u00f4kazov, \u017ee by finan\u010dn\u00e9 stimuly podkop\u00e1vali &#8220;vn\u00fatorn\u00fa motiv\u00e1ciu&#8221; pre zapojenie sa do r\u00f4znych foriem so zdrav\u00edm s\u00favisiaceho spr\u00e1vania a dokonca sa zd\u00e1, \u017ee stimuly funguj\u00fa aj v\u00a0pr\u00edpade takzvane &#8220;komplexn\u00e9ho&#8221; spr\u00e1vania a ako je odvykanie od faj\u010denia, ktor\u00e9 m\u00f4\u017ee by\u0165 n\u00e1ro\u010dn\u00e9 zmeni\u0165.<\/p>\n<p><strong>Pre\u010do nie s\u00fa finan\u010dn\u00e9 stimuly pri zmene so zdrav\u00edm s\u00favisiaceho spr\u00e1vania pou\u017e\u00edvan\u00e9 v praxi viac?<\/strong><\/p>\n<p>K\u00fdm finan\u010dn\u00e9 stimuly pre spr\u00e1vanie s\u00favisiace so zdrav\u00edm m\u00f4\u017eu dobre &#8220;fungova\u0165&#8221; v te\u00f3rii, v praxi m\u00f4\u017ee by\u0165 ich pou\u017eitie ve\u013emi problematick\u00e9. Na dosiahnutie pln\u00e9ho potenci\u00e1lu intervencie by na jednej lodi museli by\u0165 v\u0161etci &#8211; od tvorcov polit\u00edk tvoriacich samotn\u00e9 programy, cez \u013eud\u00ed v\u00a0prvej l\u00ednii, ktor\u00ed programy realizuj\u00fa, cez verejnos\u0165, a\u017e po \u013eud\u00ed, ktor\u00ed s\u00fa na strane prij\u00edmate\u013eov tvorenej intervencie.<\/p>\n<p>Ke\u010f hovor\u00edme s \u013eu\u010fmi o finan\u010dn\u00fdch stimuloch pre odvykanie od faj\u010denia, zapojenie sa do pravidelnej fyzickej aktivity, o\u010dkovania a rutinn\u00e9ho scr\u00edningu rakoviny, m\u00e1me tendenciu stretn\u00fa\u0165 sa s negat\u00edvnymi reakciami. V\u0161eobecne panuje zhoda, \u017ee stimuly by mohli podpori\u0165 niektor\u00fdch \u013eud\u00ed, aby sa zapojili do zdrav\u0161ieho spr\u00e1vania. To sa v\u0161ak zd\u00e1 by\u0165 potla\u010den\u00e9 silnej\u0161\u00edm pocitom, \u017ee stimuly s\u00fa v\u00fdrazne v neprospech \u013eud\u00ed, ktor\u00ed &#8220;robia spr\u00e1vnu vec&#8221; aj bez nich. Je tu tie\u017e obava, \u017ee \u013eudia bud\u00fa podv\u00e1dza\u0165 a &#8220;zneu\u017e\u00edva\u0165&#8221; syst\u00e9m t\u00fdm, \u017ee bud\u00fa o svojom spr\u00e1van\u00ed klama\u0165 s\u00a0cie\u013eom z\u00edska\u0165 odmenu, ktor\u00e1 nie je opr\u00e1vnen\u00e1. Dne\u0161n\u00e9 finan\u010dn\u00e1 kl\u00edma sa zd\u00e1 by\u0165 za postojom, \u017ee d\u00e1va\u0165 peniaze pre\u010d v\u00a0takejto forme nem\u00f4\u017ee by\u0165 finan\u010dne efekt\u00edvne, alebo dokonca cenovo dostupn\u00e9 a \u017ee ak\u00fdko\u013evek finan\u010dn\u00fd stimul by mali by\u0165 iba malej hodnoty. S\u00fa tie\u017e ur\u010dit\u00e9 obavy, \u017ee pr\u00edjemcovia by mohli min\u00fa\u0165 svoje odmeny na nezdrav\u00e9 produkty. Z\u00e1konodarcovia sa tie\u017e ob\u00e1vaj\u00fa, \u017ee stimuly nerie\u0161ia \u0161ir\u0161ie soci\u00e1lne determinanty nezdrav\u00e9ho spr\u00e1vania, a \u017ee tieto z\u00e1sahy je \u0165a\u017ek\u00e9 obh\u00e1ji\u0165 pred politikmi a m\u00e9diami.<\/p>\n<p>Vo v\u0161etk\u00fdch na\u0161ich kvalitat\u00edvnych \u0161t\u00fadi\u00e1ch boli na\u0161i \u00fa\u010dastn\u00edci naklonen\u00fd my\u0161lienke pon\u00faknu\u0165 alternat\u00edvne pr\u00edstupy k zlep\u0161eniu so zdrav\u00edm s\u00favisiaceho spr\u00e1vania &#8211; najm\u00e4 prostredn\u00edctvom vzdel\u00e1vania a osvety. Z\u00e1rove\u0148 sa zd\u00e1, \u017ee pon\u00fakanie finan\u010dn\u00fdch stimulov nie je &#8220;zrejm\u00fdm&#8221; rie\u0161en\u00edm pre v\u00e4\u010d\u0161inu \u013eud\u00ed, a\u00a0maj\u00fa pocit, \u017ee by predt\u00fdm mali by\u0165 vy\u010derpan\u00e9 in\u00e9 sp\u00f4soby.<\/p>\n<p>Je v\u0161ak zauj\u00edmav\u00e9, \u017ee pri realiz\u00e1cii on-line prieskumov nach\u00e1dzame pomerne odli\u0161n\u00e9 v\u00fdsledky. Dvakr\u00e1t sme zistili, \u017ee \u013eudia vn\u00edmaj\u00fa programy zameran\u00e9 na zmenu so zdrav\u00edm s\u00favisiaceho spr\u00e1vania, ktor\u00e9 zah\u0155\u0148aj\u00fa finan\u010dn\u00e9 stimuly ako rovnako alebo viac l\u00e1kav\u00e9 ne\u017e programy bez stimulov. Jedno z\u00a0mo\u017en\u00fdch vysvetlen\u00ed je, \u017ee \u013eudia chr\u00e1nen\u00ed anonymitou internetu omnoho otvorenej\u0161ie vyjadruj\u00fa svojich zi\u0161tn\u00e9 tendencie! Iste, m\u00f4\u017eeme o\u010dak\u00e1va\u0165 aj ist\u00fa &#8220;soci\u00e1lne \u017eiaducu&#8221; zaujatos\u0165, ktor\u00e1 ovplyv\u0148uje to, \u010do \u013eudia vn\u00edmaj\u00fa ako \u00a0prijate\u013en\u00e9 pri rozhovoroch o finan\u010dn\u00fdch stimuloch v\u00a0r\u00e1mci fokusov\u00fdch skup\u00edn alebo rozhovorov.<\/p>\n<p>Kult\u00fara a kontext sa tie\u017e zdaj\u00fa by\u0165 d\u00f4le\u017eit\u00e9, a existuj\u00fa i ur\u010dit\u00e9 d\u00f4kazy, \u017ee finan\u010dn\u00e9 stimuly pre spr\u00e1vanie s\u00favisiace so zdrav\u00edm s\u00fa v USA prijate\u013enej\u0161ie ne\u017e vo Ve\u013ekej Brit\u00e1nii &#8211; sn\u00e1\u010f preto, \u017ee je prirodzenej\u0161ie prepoji\u0165 peniaze a zdravie (zdravotn\u00fa starostlivos\u0165) v USA ako je tomu vo Ve\u013ekej Brit\u00e1nii (ktor\u00e1 m\u00e1 zn\u00e1rodnen\u00fd syst\u00e9m zdravotnej starostlivosti).<\/p>\n<p><strong>Odpor\u00fa\u010dania pre prax<\/strong><\/p>\n<p>Finan\u010dn\u00e9 stimuly ur\u010dite m\u00f4\u017eu by\u0165 efekt\u00edvnym sp\u00f4sobom ako pom\u00f4c\u0165 \u013eu\u010fom zmeni\u0165 ich spr\u00e1vanie s\u00favisiace so zdrav\u00edm. Nie s\u00fa v\u0161ak v\u0161eobecne platn\u00e9. Ak\u00fdko\u013evek motiva\u010dn\u00fd program by mal by\u0165 realizovan\u00fd s n\u00e1le\u017eit\u00fdm zrete\u013eom na pr\u00edpadn\u00e9 obavy \u013eud\u00ed t\u00fdkaj\u00face sa t\u00fdchto programov. To m\u00f4\u017ee zah\u0155\u0148a\u0165: \u2022 pon\u00fakanie men\u0161ej finan\u010dnej hodnoty stimulov k zn\u00ed\u017eeniu obavy, \u017ee peniaze s\u00fa &#8220;premrhan\u00e9&#8221; \u2022 pon\u00fakanie n\u00e1kupn\u00fdch poukazov miesto hotovosti, aby sa zn\u00ed\u017eila pravdepodobnos\u0165, \u017ee odmeny sa vynakladaj\u00fa na nezdrav\u00e9 produkty \u2022 zabezpe\u010denie, aby boli programy dobre monitorovan\u00e9 s\u00a0cie\u013eom uisti\u0165 sa, \u017ee \u013eudia nebud\u00fa &#8220;zneu\u017e\u00edva\u0165&#8221; syst\u00e9m \u2022 vkladanie finan\u010dn\u00fdch stimuly do \u0161ir\u0161\u00edch programov v\u00a0r\u00e1mci intervenci\u00ed, ktor\u00e9 zah\u0155\u0148aj\u00fa vzdel\u00e1vanie a inform\u00e1ciu o\u00a0zdravom spr\u00e1van\u00ed<\/p>\n<p>U\u017eito\u010dn\u00e9 by mohlo by\u0165 zah\u00e1ji\u0165 otvoren\u00fd a \u00faprimn\u00fd rozhovor vo vn\u00fatri komun\u00edt sk\u00famaj\u00faci kedy, kde a ako by finan\u010dn\u00e9 stimuly mohli by\u0165 najvhodnej\u0161ie.<\/p>\n<p>&nbsp;<\/p>\n<p><em>Translation: Zuzana Dankulincov\u00e1<\/em><\/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":"sk","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\/sk\/wp-json\/wp\/v2\/posts\/222","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/comments?post=222"}],"version-history":[{"count":29,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/222\/revisions"}],"predecessor-version":[{"id":4652,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/222\/revisions\/4652"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media\/236"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media?parent=222"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/categories?post=222"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/tags?post=222"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}