After you have scanned the external environment surrounding the health issue you want to address, you now understand the drivers and challenges of your potential PSE change initiative. However, you need evidence to support your position. Assess and review available data to determine which specific aspect of the health issue can be potentially resolved or lessened through PSE change. Your state, tribe or territory cancer control plan is a great place to start.

Data can be quantitative or qualitative and can be found in various sources including state and federal surveillance programs and published research. Review quantitative data such as cancer surveillance data for your state, tribe or territory. Look for qualitative data collected through focus groups or key informant interviews as well as anecdotes collected through community meetings and other methods. Seek local-level data to inform your community-based efforts.



Data can play an important role in identifying the priority areas of your PSE change initiative. The following tips may be helpful as you consider how to best use data as evidence to build a strong foundation for your PSE change effort and create specific, measurable, attainable, relevant and time-bound (SMART) objectives.

  • Take a broad view of the data available; for example, consider behavioral risk factors surveillance, cancer surveillance and policy data like tobacco excise tax rates.
  • Include sources for your state, tribe or territory data, as well as regional and local data if they are available. Using data specific to the sub-population in your community and highlighting health disparities (if they exist) builds a stronger case for why the PSE change is needed for your intended audience.
  • Look for data related to cost-benefit analysis. Comprehensive cancer control programs operate in an environment of limited resources. One of the first questions posed by stakeholders and decision-makers likely will relate to the cost of the proposed PSE change. Be prepared to estimate the strengths and weaknesses of your initiative against alternative types of action.
  • Review your state’s comprehensive cancer control plan to see what work already has been done in your area of interest and what evaluation data are available.
  • If necessary (and feasible), consider collecting primary data through key informant interviews, focus groups or surveys to fill any data gaps and support your case.
  • Make sure your data are evidence-based, objective, reliable and valid and use this evidence to build SMART goals and objectives.


Below is a list of resources focused on Step 3 of the PSE change approach (identify priority areas):

  • Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS) is “the nation’s premier system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services.”
  • Community Health Assessment and Group Evaluation (CHANGE:) Building a Foundation Knowledge to Prioritize Community Needs – An Action Guide – “This action guide provides step-by-step instructions for successfully completing the CHANGE tool. CHANGE can be used to gain a picture of the policy, systems, and environmental change strategies currently in place throughout the community; develop a community action plan for improving policies, systems, and the environment to support healthy lifestyles; and assist with prioritizing community needs and allocating available resources.”
  • County Health Rankings & Roadmaps – Together with Roadmaps, which provide tools to understand and use the data, the annual County Health Rankings compile county-level information on a wide range of health factors, such as access to health foods, obesity, and smoking.
  • National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program “provides information on cancer statistics in an effort to reduce the cancer burden among the U.S. population.” Here you can use interactive tools and develop maps, graphs and other visualizations of cancer data.
  • PubMed Central® is a “free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine.” Start here for literature searches to find open source articles.
  • See the resources page for more data, statistics and visualization resource suggestions.
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