the former Kil-Tone Company NPL site. The APPLETREE program at the New Jersey Department of Health worked closely with local health departments and federal agen- cies, shared public health assessment find- ings, and provided outreach to community members on ways to reduce their exposures and protect their health. The closeness of APPLETREE partners to site-specific issues enhances the public health assessment process and the ability of ATSDR to protect people’s health. Strong local partnerships also support timely site health assessments and recommendations. Community Engagement Community engagement is critical to under- standing the needs of a community and involv- ing them in the public health assessment process. ATSDR (2021) and APPLETREE partners seek an in-depth understanding of the unique attributes, historical experiences, and goals of a community to inform a success- ful engagement strategy. Community engage- ment helps accomplish the following goals (ATSDR, 2022a): • Build trust, support, and open dialogue between community members and the site team. • Identify and understand the health con- cerns, unique needs, and preferences of the community. • Promote community participation in the public health assessment process. •Obtain community support for taking actions that will protect people from harm- ful exposures to site-related contaminants. • Engage new resources and allies. • Address overall community health concerns and improve community health outcomes. ATSDR and APPLETREE partners develop outreach materials such as facts sheets, videos, and training, as well as participate in public meetings and workshops (Grants.gov, 2022). They also conduct Soil Screening, Health, Outreach, and Partnership (soilSHOP) events that provide community members with free lead screening of soil gathered from their gar- dens or outdoor play areas. These soilSHOP events provide health education and outreach about potential lead exposures and ways to protect communities from lead (ATSDR, 2022b). For example, the APPLETREE pro- gram at the Tennessee Department of Health conducted a soilSHOP to screen soil for lead
from the Southside Chattanooga Lead NPL site neighborhood. Their eorts helped inform community members about the importance of testing their soil for lead and actions that can reduce or prevent lead exposure. Com- munity engagement activities ensure that community members understand the findings of health assessments and, where applicable, adopt behavioral changes to reduce harmful environmental exposures and improve health (ATSDR, 2022a). Newly licensed early care and education centers might inadvertently locate learn- ing facilities in areas where children could be exposed to harmful environmental sub- stances (ATSDR, 2017). To help support children’s health, APPLETREE integrated the CSPECE initiative into the program in 2017. CSPECE promotes environmentally safe siting of early care and education (ECE) centers through local partnership build- ing, improved data use, pilot programs, and other activities. Choose Safe Places for Early Care and Education APPLETREE state partners create innova- tive solutions such as training programs, vol- untary property questionnaires, videos, and other resources to help ECE facility owners make informed decisions. For instance, the APPLETREE program at the Pennsylvania Department of Health developed a volun- tary online survey for childcare owners and operators that encouraged having a healthy environment for ECE centers. Several state programs have realized positive eects of CSPECE on local, state, and federal childcare policies and procedures, and in preventing unsafe siting of ECE centers. Sustainability planning for partner CSPECE programs is encouraged and important to achieve positive health outcomes. Appletree Eects and Successes APPLETREE has had positive eects on pub- lic health in many communities. In its 36 years, APPLETREE has funded programs in 39 states and awarded more than $250 mil- lion. Nearly two thirds of all ATSDR site investigations are conducted through the APPLETREE program. Those investigations have reduced or prevented harmful envi- ronmental exposures from many hazardous waste sites.
Over the past 3 years, APPLETREE assessed approximately 2.5 million people for hazard- ous exposures. Funded partners also devel- oped innovative ways to engage and educate communities about public health risks from potential exposures to site contaminants. CSPECE programs are helping childcare oper- ators make informed decisions about potential ECE locations. APPLETREE partners con- tinue to achieve positive eects through inno- vative prevention-based activities. APPLETREE started a new 5-year program period on April 1, 2023. To learn more, visit www.atsdr.cdc.gov/states/index.html. Corresponding Author: Audra Henry, Pro- gram Services Section Chief, Oce of Capac- ity Development and Applied Prevention Science, Agency for Toxic Substances and Disease Registry. Email: ate1@cdc.gov. References Agency for Toxic Substances and Disease Registry. (2017). Choose Safe Places for Early Care and Education (CSPECE) Guid- ance Manual . https://www.atsdr.cdc.gov/ safeplacesforECE/docs/Choose_Safe_ Places_508_final.pdf Agency for Toxic Substances and Disease Registry. (2021). Community Engage- ment Playbook . https://www.atsdr.cdc.gov/ ceplaybook/index.html Agency for Toxic Substances and Disease Registry. (2022a). Public Health Assessment Guidance Manual (PHAGM) . https://www. atsdr.cdc.gov/pha-guidance/ Agency for Toxic Substances and Disease Registry. (2022b). soilSHOP Toolkit. https:// www.atsdr.cdc.gov/soilshop/index.html Grants.gov. (2022). View grant opportunity: ATSDR’s Partnership to Promote Local Eorts to Reduce Environmental Exposure (CDC-RFA-TS-23-0001). https://www. grants.gov/web/grants/view-opportunity. html?oppId=340900 New Jersey Department of Health. (2023). Public health assessment: Public health implications of exposures to site contami- nants, former Kil-Tone Company, Vineland, New Jersey, EPA facility ID: NJN000200874 . https://www.atsdr.cdc.gov/HAC/pha/ Kil-Tone/Former-Kil-Tone-Company- PHA-508.pdf
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