The nuts & bolts of PSE

PSE, or policy, systems, and environmental change, is an approach to addressing the larger structures that affect a communities’ health. Unlike traditional efforts that aim to change a person’s behaviors or attitudes, PSE focuses on all the uncontrollable factors in a person’s life that make it extremely hard to change their behaviors or attitudes.

For example, we might encourage a community to eat fresh fruits and vegetables, but if the community doesn’t have a grocery store, then our efforts will likely be ineffective. In this scenario, PSE would help us identify and implement the most appropriate systems change to make it easier for community members to access fresh foods.

Before we discuss ways to develop and implement successful PSE efforts and all the benefits you can expect from incorporating PSE, let’s break down the approach in more detail.


A policy is described as a written set of rules at an organizational, local, state, or national level. Policies often have a big impact, both positive and negative, on community health and well-being. Many health and social service organizations are actively engaged in changing harmful policies, as well as creating and advocating for policies that will improve community outcomes.

Can you think of any policies that directly affect your organization and community?

Some examples of policy changes include:

  • Schools requiring healthy options during afterschool events
  • Creating a policy to implement smoke-free zones in public areas
  • Changing local zone ordinances to support corner stores in food deserts


System changes are implemented to support policy change. These changes aim to influence the systems within organizations, institutions, and other groups that are improving or hindering healthy outcomes. Think of the systems within your organization or community; which ones support healthier choices?

Some examples of system changes include:

  • Organizational procedures that support wellness breaks
  • Adding healthy options to vending machines at schools
  • Implementing the Safe Routes to Schools Program across the state


Environmental changes are physical, social, or economic changes made to the environment. Physical changes may include any structural changes or improvements to existing areas. Social changes include changes in behaviors/attitudes that support positive health behavior change. Economic changes may include incentives or monetary support to encourage positive health behavior change.

Can you think of any environmental changes that could support healthy changes in your community?

Some examples of environmental changes include:

  • Implementing a city-wide smoke-free air ordinance act
  • Marketing and advertising healthy food options in restaurants
  • Placing signage on walking/biking routes


As you may have gathered, implementing PSE changes is hard work. But the benefits are tremendous!

PSE interventions allow you to promote positive health behavior change on a much broader scale than just the individual level. These far-reaching interventions ensure you will have a greater impact in organizations and communities of all sizes.

Since most PSE efforts are undertaken by a collaborative of organizations, you’ll benefit from increasing the quantity and quality of your partner relationships.

PSE work can also make you more competitive for grants and individual donations. Many funders understand the impact PSE changes can have on communities so they may be more likely to fund you when they see you’re aligning your efforts with PSE changes.

Perhaps the most exciting benefit is that policy, system, and environmental changes build upon each other. For example, system and environmental changes may develop as a result of implementing policy changes on an organization level. And by working with decision and policy makers, you can develop and implement interventions that positively affect existing efforts.


It may seem overwhelming to develop and implement PSE change in your community, especially if this is something new to you. And at this point, you may have questions on how to develop successful efforts, so let’s take a look.

Here are my top 8 tips for successful PSE efforts:

  • Start now and focus on making PSE changes at your organization. By focusing on your organization first, you will gain a deeper understanding of PSE and help support positive changes for your employees. Small changes such as making water available, developing a wellness policy for employees, and incorporating walking meetings are great ways to start!
  • Support an upstream approach and integrate PSE efforts into your existing programming areas.
  • Engage your partners in your PSE efforts to support greater impact and sustainability. By working together, you can also identify the needs of your community and develop potential solutions.
  • Identify and use local data from community health and needs assessments to support PSE changes in the community.
  • Develop PSE change interventions that link directly with your community’s goals and objectives.
  • Communicate. Speak with your decision and policy makers to influence community-level change.
  • Share! Document your barriers to implementation and lessons learned.
  • Be patient! PSE changes are long-term efforts and may take up to at least 3-5 years to demonstrate results.

Today, I challenge you to develop and implement a PSE change in your organization or community setting. Contact your partners and see how you can work together to support your efforts. Often, organizations are already supporting PSE changes with their direct education efforts but are unaware they are doing so. Through the tips provided above, you can now brainstorm ways to develop and implement PSE change. Work to develop an upstream approach to support behavior change. And, don’t forget to share your successes.

Until next time!

Do you have any tips to share on developing and implementing successful PSE efforts?
Please share below!

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Grant Readiness

March 5, 2019

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