If your coalition is like most comprehensive cancer control coalitions, when you hear the words “policy, system and environmental change” or PSE, you might think:
Policy change? We can’t do that can we?
System change? That’s too hard!
Environmental change? That’s too costly.
If you have had these thoughts, you are not alone. We often think large scale change is too difficult, costly and not possible. But, look at these strategies from current CCC plans:
- Decrease tobacco industry marketing to minors at point-of-sale checkout counters.
- Ensure that adequate opportunities for safe physical activity are available (e.g. built environments, green spaces, community recreation facilities, walking trails and safe sidewalks).
- Work with organizations such as 4-H, Boy Scouts, Girl Scouts, and Boys and Girls Clubs to include sun safety education within their programs and/or to develop policies or recommendations surrounding sun safety at their events.
- Ensure that the implementation of the Patient Protection and Affordable Care Act in our state includes access to breast cancer screening, diagnostic, and treatment services.
- Promote the use of survivor care plans by patients, healthcare providers and systems.
- Collaborate with the Office of Public Instruction to advocate for best policies and practices for childhood cancer survivors and their siblings.
If you thought “these look familiar” or “our coalition could do that” then you are already working on PSE changes or could begin to work on them.
PSE changes are focused on “upstream” or early factors that use legislative, community or organizational change to positively affect the world we live in. PSE efforts result in long-lasting sustainable change that doesn’t just rely on individual behavior change, but also creates the environment to either make it easier (eat healthier, increase access to screening, exercise more) or harder (restrict smoking, remove soda machines in schools) to engage in an individual behavior. PSE change is upstream change that helps individuals do what they need to do to get and stay healthy.
So, as a CCC coalition, how do you choose which PSE changes to work on? As a starting point, look at the current priorities your coalition is working on or the strategies listed in your CCC plan. Ask yourself: are any of these policy, system or environmental change strategies? If you answer yes, that’s great. Make sure your coalition members understand that they are working on PSE changes and encourage your teams to access tools and resources to ensure quality implementation of PSE strategies, such as:
CDC’s Communities Putting Prevention to Work Program Resource Center http://www.cdc.gov/CommunitiesPuttingPreventiontoWork/resources/index.htm
CDC’s CHANGE Tool: Community Health Assessment aNd Group Evaluation Tool http://www.cdc.gov/healthycommunitiesprogram/tools/change.htm
American Cancer Society Cancer Action Network Resources
Michigan Cancer Consortium’s PSE Web Page
If you answer no, that your coalition is not working on PSE changes, then look at your plan and see if any PSE strategies are already in your plan. Consider choosing these PSE strategies as you work on your cancer plan priority objectives. If you look at your cancer plan and realize there are no PSE strategies, talk with your coalition leadership to see if you should consider incorporating PSE change into your CCC plan implementation.
For an innovative view of upstream change, check out Rebecca Onie’s TED Talk, What if our healthcare system kept us healthy?
Join us for next month’s Coalition Corner conversation when we continue focusing on PSE change and highlight some examples of CCC coalitions successfully working on PSE change strategies. But, you don’t need to wait until then: Join the conversation now! What kinds of PSE change strategies is your coalition working on now?