 Determining and assessing the links between human pressures and state changes in marine and coastal ecosystems remains a challenge. The DPSIR, Drivers, Pressures, State Change, Impact, Response framework has been widely adopted. However, there is less use of DPSIR in fully marine ecosystems and even this was mainly restricted to European literature. This article was authored by Joanna Patricio, Michael Elliott, Krisha Mazik, and others.