The George Washington University (GW) Cancer Center’s Action for PSE Change tool is an online platform to help comprehensive cancer control professionals, coalitions and communities with improving health across the cancer continuum through Policy, Systems and Environmental (PSE) changes. This platform offers basic information on the PSE change approach and resources on where to find and how to use cancer data and other resources to advance PSE change efforts. It will also help users learn from successful PSE change examples in the area of cancer control.

What is Policy, Systems & Environmental (PSE) Change?

The PSE change approach “supports the improved health and well-being of individuals and families through a comprehensive and practical approach” (American Cancer Society, 2015). PSE changes are public health changes that enable healthy options and allow the healthy choice to become the easy choice (Truss, 2013). PSE change can address disparities in cancer care and lead to improved health outcomes by maximizing the reach and extending the impact of cancer control interventions to the population level.

Policy Systems Environment
Definition Changing laws, regulations, resolutions, ordinances or rules Changing processes or rules of an organization, institution or system Physically changing the environment
Settings Legislatures (national, state or local), government administrations, health care settings, schools, worksites, community organizations (e.g., faith-based, daycare, senior center) Health care delivery and insurance systems, tribal organizations, schools, worksites, communities Physical (e.g., stores, schools, worksites, parks, health clinics/offices), economic or social environments
Examples Increasing tobacco taxes, implementing a school-entry vaccination policy Developing a community plan that accounts for health impact of projects, reviewing and revising organizational procedures to increase cancer screening rates among patient population Constructing sidewalks to make roads pedestrian-friendly, designating a lactation room for nursing mothers at work
Overlapping Examples

Many PSE changes include combinations of policy, systems and environmental change:

Smoke-free policies (e.g., legislature, hospital grounds, college campus, worksite)
Healthy vending machine policy for a school system
Adding night or weekend health care provider or clinic hours
Zoning restrictions or limitations on fast food establishments
Farm-to-school healthy school lunch program

This table was adapted from Truss (2013).


American Cancer Society. (2015). Policy, Systems and Environmental Change Resource Guide. Retrieved from https://smhs.gwu.edu/cancercontroltap/sites/cancercontroltap/files/PSE_Resource_Guide_FINAL_05.15.15.pdf

Truss, M. (2013). Policy, Systems and Environmental Change in Cancer Control. [PowerPoint slides]. Retrieved from http://phpa.dhmh.maryland.gov/cancer/cancerplan/SiteAssets/SitePages/publications/PSE%20Presentation%20FINAL.pps