What Is Policy, Systems and Environmental (PSE) Change?

 Policy, systems and environmental change approaches seek to go beyond programming and into the systems that create the structures in which we work, live and play. These approaches often work hand‐in‐hand where, for example, an environmental change may be furthered by a policy or system change. Similarly a policy could be put in place that results in additional environmental changes. The process is not linear.

At the end of the day, an effective PSE approach should seek to reach populations and uncover strategies for impact that are sustainable. Efforts may accelerate the adoption or implementation of effective interventions by effectively integrating approaches into existing infrastructures. Such approaches often include advocates, decision and policy makers.1


Event/Program vs. PSE Change

Characteristics of Event or Program Characteristics of PSE Change
One time Ongoing
Additive: often results in only short‐term

behavior change

Foundational: often produces behavior

change over time

Individual level Community/Population level
Not part of ongoing plan Part of an ongoing plan
Short term Long term
Non‐sustaining Sustaining



What is Policy Change?

Policy change includes policies at the legislative or organizational level. For example, institutionalizing new rules or procedures as well as passing laws, ordinances, resolutions, mandates, regulations, are all examples of policy change efforts. Government bodies (federal, state, local level), school districts and schools, park districts, healthcare organizations (hospitals, health systems), worksites, and other community institutions (jails, daycare centers, senior living centers, faith institutions) all have and make policies.


Examples include:

  • Changing local zoning ordinances so that corner markets can display produce outdoors
  • Provision of county or city public land (or previously vacant land) for green spaces or farmers’
  • Changing community park laws to allow fruit trees
  • Establishing healthy concession stand policies in local parks or recreation facilities


1  Robert Wood Johnson Foundation


  • Schools requiring healthy food options for all
  • School policy that prohibits unhealthy food in school fundraising
  • Passing a law allowing residents to plant community gardens in vacant
  • A human resources policy that requires healthy foods to be served at



What is Systems Change?

Systems change involves change made to the rules within an organization. Systems change and policy change often work hand‐in‐hand. Often systems change focuses on changing infrastructure within a school, park, worksite, or health setting or instituting processes or procedures at the system level that ensure a healthier workplace. Examples are:

  • Screening for Hunger in Hospitals and developing ongoing mechanisms to refer hungry residents to food
  • Farm to School programs
  • Connecting emergency food providers with local growers in a sustainable way
  • Creating a community plan to account for health impacts of new
  • Implementing the national school lunch program across the state school
  • Creating a certification process for school bake sales to ensure they are in line with school wellness



What is Environmental Change?

Environmental change is change made to the physical environment. Physical (Structural changes or programs or service), social (a positive change in attitudes or behavior about policies that promote health or an increase in supportive attitudes regarding a health practice), and economic factors (presence of financial disincentives or incentives to encourage a desired behavior) influence people’s practices and behaviors. While related to the environment, such changes are not isolated to a few households or individuals, but instead reflect a population‐ focused effort. Examples of changes to the environment might include:

  • Incorporating sidewalks, paths, pedestrian friendly intersections, and recreation areas into community design (complete streets policy).
  • Installing signage on already established walking or biking
  • Municipality planning process to ensure better pedestrian and bicycle access to main roads and
  • Availability of healthy food choices in restaurants or
  • Increase in acceptance of limiting candy as rewards in classrooms across a school
  • Charging higher prices for less healthy products to decrease their
  • Provision of health insurance discounts or bonus dollars for those who exercise


                                                            Examples of PSE Change in Different Settings                                                           

Setting Policy Change* Systems Change* Environmental Change*
School Los Angeles School District Healthy Beverage Resolution prohibits the sale of soda in vending machines, student stores, and cafeterias at LAUSD school sites. Farm to School: District switches procurement and cooking systems to incorporate fresh, local produce and other foods into school meals and integrates it with classroom based education about healthy eating. Gardens: Garden built on vacant water district land adjacent to school exposes students to fresh produce while teaching them about how food is grown
Community Safe Routes to School ‐ City adopts

policy reducing speed limit near school in order to encourage safe‐routes to school and pedestrian safety.

Local Food to Retail: City

procurement systems change to source only healthy food for vending machines.

Farmer’s Markets: Small‐

farmers markets are opened at community based organizations and clinics in underserved areas

Worksite Santa Clara Healthy Food Policy

Requires 50% of food and beverages sold in County vending machines meet specific nutrition guidelines and sets nutrition standards for county sponsored meetings and events.

Reimburse Prevention:

Reimburse employees for preventive health and wellness activities

Healthy Options: Healthy

food options are available for employees during the workday and at all meetings

Hospital Hospital adopts a policy and process for operation of Farmers’ Markets onsite at the County Hospital, and other County properties. Referral Systems: Develop a referral system to help patients access further nutrition and physical activity resources. Farmer’s Markets: Onsite Farmers’ Market enhances staff and community access to fresh produce.

*Note: Process is not necessarily linear (policy change à environmental change OR environmental change à policy change);

*Adapted from the Environmental Nutrition and Activity Community Tool (ENACT): http://eatbettermovemore.org/sa/enact/members/index.php

and Local Policy Database: http://eatbettermovemore.org/sa/policies/ ** Ado