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Climate awareness, anxiety, and actions among youth: a qualitative study in a middle-income country

Abstract

Objectives:

The impact of climate change on mental health is well established, but few studies have examined the perspectives of young people, especially in low- and middle-income countries (LMICs). In this qualitative study, we explored how Brazilian children and adolescents experience climate change. This approach can help inform environmental education, communication, and self-care strategies for this age group.

Methods:

We conducted focus groups with 50 children and adolescents aged 5 to 18 years in three locations in Brazil. We analyzed the data using an interpretative phenomenological analysis framework.

Results:

We identified three profiles of involvement with climate change: unaware, disengaged, and engaged. Profiles were largely related to different socioeconomic contexts. We analyzed each profile across the dimensions of space, time, emotions, and actions. Adults were portrayed by participants as stubborn deniers, as neutral influences, or as role models of knowledge and engagement. Due to their age and developmental level, young children had distinctive perceptions of climate change.

Conclusion:

Spatial and temporal perceptions of climate change are a key element for experiencing and engaging with environmental concerns and vary according to age and socioeconomic differences. Effective communication to foster climate action at individual and collective levels requires narratives that reach different ages. Replication of these findings in other LMICs is warranted.

Climate change; eco-anxiety; children; adolescents; social inequality


Introduction

Climate change poses a significant threat to the well-being of ecosystems, societies, and individuals, with an increasing number of studies highlighting its consequences for mental health.11. World Health Organization (WHO). Checklists to assess vulnerabilities in health care facilities in the context of climate change [Internet]. 2021 [cited 2022 June 29]. https://www.who.int/publications-detail-redirect/9789240022904
https://www.who.int/publications-detail-...
Children and adolescents have intrinsic vulnerabilities that lead to an increased risk of experiencing psychological distress as a result of climate change.22. Crandon TJ, Scott JG, Charlson FJ, Thomas HJ. A social-ecological perspective on climate anxiety in children and adolescents. Nat Clim Change. 2022;12:123-31. Some young people also experience emotional distress related to climate change, which is characterized by feelings of anger, guilt, and despair.33. Albrecht G. Chronic environmental change: emerging ‘psychoterratic’ syndromes. In: Weissbecker I, editor. Climate change and human well-being. New York: Springer; 2011. p. 43-56. These feelings are considered an appropriate, adaptive, and non-pathological response to ecological losses.44. Clayton S, Manning C, Speiser M, Hill AN. Mental health and our changing climate: impacts, inequities, responses [Internet]. 2021. https://www.apa.org/news/press/releases/mental-health-climate-change.pdf
https://www.apa.org/news/press/releases/...
Apathy and inaction toward climate change on the part of those in power, such as adults and governments, reinforce these negative emotions and thought patterns.55. Hickman C, Marks E, Pihkala P, Clayton S, Lewandowski RE, Mayall EE, et al. Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. Lancet Planet Health. 2021;5:e863-73.

The lack of effective communication around climate change has led to a discrepancy between the scientific community’s increasing certainty about anthropogenic human interference in climate and the public’s limited concern about effective climate policies.66. Stoknes PE. What we think about when we try not to think about global warming: toward a new psychology of climate action. Vermont: Chelsea Green Publishing; 2015. Despite the impact of climate change on children, environmental actions led by young people have been met with ambivalent responses. News media often portray children and adolescents as immature and subject to the will of adults around them. Such portrayals, in addition to devaluing and obscuring young people’s subjective experiences and beliefs, further complicate the task of helping young people respond to climate change.77. Benoit L, Thomas I, Martin A. Review: Ecological awareness, anxiety, and actions among youth and their parents – a qualitative study of newspaper narratives. Child Adolesc Ment Health. 2022;27:47-58.

Few studies have sought to understand children’s experiences and feelings about the issue; what research does exist tends to center on high-income countries and utilize small samples of adolescents, usually aged 15 or older.77. Benoit L, Thomas I, Martin A. Review: Ecological awareness, anxiety, and actions among youth and their parents – a qualitative study of newspaper narratives. Child Adolesc Ment Health. 2022;27:47-58. Little is known about the experiences of younger children and those in low- and middle-income countries (LMICs). Thus, this work aims to better understand children’s and adolescents’ experiences of climate change in Brazil, a middle-income country marked by social and economic inequalities. Additionally, we seek to elucidate more effective forms of climate-change communication to help young people move from fear and paralysis to hope and action.

Methods

Sample

Our study represents one branch of a larger research study on young people’s perceptions of climate change in France, the United States, and Brazil, conducted in 2021 and 2022. For this study, we interviewed 50 Brazilian children in different regions of the country: the cities of São Paulo (state of São Paulo) and Salvador (state of Bahia), as well as several villages of Ilha de Itaparica (state of Bahia). The participants were children and adolescents between the ages of 5 and 18, sampled by convenience. Some of the interviewees were known to the researchers and were recruited face-to-face, while others were recruited through a school to which we advertised the project via e-mail. Participants and their parents provided oral consent. Two adolescents were invited but could not participate, due to schedule incompatibility with the other focus group participants. We also interviewed three parents of young children; these interviews were audio-recorded, transcribed, and analyzed using the same methodology as the interviews of children and adolescents. The results obtained in the parents’ interview provided a better picture of the situations reported, which the young children occasionally had difficulty describing.

Study setting

Most of the participants from São Paulo came from schools in the central-west and central-south zones of the city, regions with a high socioeconomic level. However, four participants were from smaller cities (Santo André and São Bernardo) that are part of the São Paulo metropolitan region.

Bahia belongs to the poorest region of Brazil, where 43.5% of the population lives in poverty (defined as subsisting on less than USD 2/day88. Instituto Brasileiro de Geografia e Estatística. Panorama dos estados – Bahia [Internet]. 2017. https://cidades.ibge.gov.br/brasil/ba/panorama
https://cidades.ibge.gov.br/brasil/ba/pa...
) and where crime rates are the highest in the country.99. Bretas V. Exame [Internet] Os estados mais violentos do Brasil. 2017 Nov 04. https://exame.com/brasil/os-estados-mais-violentos-do-brasil-3/
https://exame.com/brasil/os-estados-mais...
Salvador is a coastal city, the capital of the state of Bahia, with a population of approximately 3 million; Ilha de Itaparica is an island with a total population around 22,000 and a low population density (176/km2). On Ilha de Itaparica, only 9% of the population is officially employed, and 47% earns, at most, half of the monthly minimum wage in Brazil.1010. Instituto Brasileiro de Geografia e Estatística. Panorama das cidades – Itaparica. 2022. https://cidades.ibge.gov.br/brasil/ba/itaparica/panorama
https://cidades.ibge.gov.br/brasil/ba/it...
Many residents of coastal villages make their living from informal work (i.e., beach vendors, housekeepers, delivery couriers), activities related to tourism during the high season (i.e., informal transport or guided tours), and fishing. Most of the children recruited there came from public schools. Furthermore, most of the participants from this region were Black, which can be traced back to vestiges of slavery in Bahia.1111. United Nations Educational, Scientific and Cultural Organization (UNESCO). Historic centre of Salvador de Bahia. 2022. https://whc.unesco.org/en/list/309/
https://whc.unesco.org/en/list/309/...
This heritage, combined with ongoing structural racism, perpetuates the association between poverty and being Black in this region.

Data collection

Three researchers (DTC, EAN, LB) were native speakers of Portuguese. DTC is of Asian descent, while EAN and LB are White; LB and DTC are female, and EAN is male. The three investigators conducted the interviews using a semi-structured guide consisting of 19 sensitizing questions, which inquired about perceptions of climate change, emotions related to climate change and coping with it, exchange of information about the topic with adults and friends, actions respondents try to take, and possible barriers they face in doing so. Interview groups ranged in size from one to nine participants, with a total of 13 groups. Five focus groups were conducted online (via Zoom) and eight in person. There were no non-participants present at the interview sites. The in-person interviews were audio-recorded, and the online interviews were audio- and video-recorded. The video record was destroyed immediately after the interview. Audio records were transcribed and anonymized to maintain confidentiality. Each interview lasted approximately 1 hour. We offered BRL 15.00 (USD 2.90) as a token of appreciation to each study participant.

Data analysis

We utilized interpretative phenomenological analysis (IPA) for this study. This methodology seeks to understand the lived experience of each person in relation to the phenomenon of interest. However, these subjective experiences cannot be reached in their pure form, but only through the researcher’s own conceptions, thus creating a two-stage interpretation process.1212. Smith JA, Osborn M. Interpretative phenomenological analysis as a useful methodology for research on the lived experience of pain. Br J Pain. 2015;9:41-2. As opposed to hypothetical-deductive research, inductive research should closely reflect the data collected, not the structure of the interview guide. The authors, prior to the interviews, actively examined their own relationship with climate anxiety, based on existing literature, previous experiences, and embedded within a specific socioeconomic context. As the interviews took place, they took notes on their impressions and thoughts regarding the content of the interviews. The material was read several times over a period of months, allowing time to provide occasions for new meanings to emerge; these impressions were taken to supervision.

Reflexivity, according to Engward & Goldspink,1313. Engward H, Goldspink S. Lodgers in the house: living with the data in interpretive phenomenological analysis research. Reflective Pract. 2020;21:41-53. occurs when interview content dwells for long periods of time in the researchers’ minds, allowing for the emergence of careful formulations of meaning that reflect the experience of the interviewees. They liken this process to a renter who dwells in the home. According to them, reflexivity is not just a task, but a way of being that takes time – this is what the authors sought to do in the steps described above.

Our aim was to inquire about children and adolescents’ feelings and actions regarding climate change. As such, our interview guide included questions about emotions, perceptions, and actions (engagement) related to climate change (Supplementary Material S1). Two researchers (DTC and EAN) independently coded all the transcripts in Portuguese. All three interviewers discussed their interpretations in Portuguese until they reached agreement through triangulation. After this process, we grouped interview quotes into themes, which we translated into English and further refined in collaboration with the rest of the research team (AM, IT). DTC and EAN are psychiatry residents, and IT is a medical student. All three them have extensive training in qualitative research. They were oriented by LB and AM, two child and adolescent psychiatrists with expertise in qualitative methods.

It is important to point out that, although the results are divided into specific topics, no categorization had been thought of prior to the analysis of the interviews; instead, one emerged from our reading of the data and division into themes and subthemes.

This research followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.1414. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349-57.

Ethics statement

The research program Earth Emotions among Children and Adolescents: Turning Eco-Anxiety into Eco-Aware Action has received approval upon expedited review from the Yale Human Research Protection Program Institutional Review Boards (IRB Protocol ID: 2000029983).

Results

Fifty children and adolescents (31 girls), ages 5 to 18, participated in the study. Demographic data are described in Table 1. We also interviewed three parents of young children, to provide broader context to their children’s statements. In the quotes presented, the age and gender (female [F]/male [M]) of participants are referred to as follows: a 12-year-old girl will be noted as “(12, F).” When we analyzed the qualitative data in an inductive way (from data to theory), we noticed that the most striking results were related to the various degrees of awareness and engagement among participants, and that these perceptions appeared to overlap with their social background. For this reason, we developed three categories, unaware, disengaged, and engaged, reflective of these three profiles.

Table 1
Sample characteristics

We developed a model that divided participants into three profiles regarding their awareness of and stance toward climate change: 1) unaware; 2) aware and disengaged; and 3) aware and engaged. We considered each of the three profiles across four dimensions: i) space (proximity of global effects of climate change); ii) time (perception of how long until dire ecological consequences take place); iii) emotions (coping with ecological change); and iv) behaviors (actions taken to prevent further impact).

Certain socioeconomic contexts tended to correlate with engagement patterns. This division was created based on the phenomenological findings and echoes the opinions of some participants from profiles 2 and 3: “There are two types of rich and poor people who deal with this situation: the rich ones either don’t care, they only think about money – or are informed and try to do as much as possible, because they have the money for it. There are two types of poor people, who either have no place to find information – or they have information, but they don’t have money to afford organic food” (12, F).

The two aware groups had heard of climate change and both were part of wealthier social classes. Many thought that the low-income population did not know about climate change: “The person who has no money may not be very informed because of education” (15, M). Some thought that even if they knew about environmentally conscious actions, there would not be much they could do: “Poor people are not in a position to make much of a difference. They can cooperate by not littering, but if you really want to make a change, you must do something that would cost more” (13, F). These participants also characterized people of lower socioeconomic status as those contributing the least to climate change, yet who will suffer its consequences the most. They mentioned that homeless people will die because of extreme temperatures, that people who live in slums will lose their homes due to landslides and floods, and people who live in more precarious urban areas will experience more pollution. These participants also portrayed the wealthier segments of society, which included themselves, in a mainly negative light: “Wealthy people may know more about news, but often may not even care about it, caring about more important things in their head? – for example, money” (13, F). A few, however, thought that the rich have more power to act because of their money. There was no mention of environmental consequences that may affect the wealthiest groups in society; only one participant said that they could be affected indirectly by climate change, through the increase in energy costs. For additional quotes by children, see Table 2. We describe the three profiles below.

Table 2
Quotes for unaware, disengaged, and engaged profiles

Unaware

The first group could be described as unaware, as they had little or no knowledge about climate change. Interviewer: “Have you heard about climate change?”; Participant: “Yes, it’s that the earth is moving closer to the sun” (10, F). Most of them lived in coastal villages, in less developed parts of Ilha de Itaparica; most of their parents had informal jobs (e.g., beach vendor, housekeeper); and most attended public schools. A few children mentioned with pride that their parents had a formal occupation (e.g., supermarket cashier) and 95% of the participants from this group were Black.

Experience of space

We did not find any spatial relationship in this profile with climate change; however, children expressed closeness to nature and awareness of natural threats. Many of them lived near the ocean and spent much of their free time playing outside. They saw garbage dumped in the streets and on the shore. All had witnessed massive floods less than 3 months before the interview: “We had to travel by canoe between the houses” (12, M).

Experience of time

These participants spoke little about the future and the past, focusing more on their everyday experiences. For many of them, it was the first time that they had heard about climate change: Interviewer: “Is this your first time hearing about it?,” Participant: “The first time” (10, M).

Emotions

Participants in this profile expressed no worries or anxiety related to climate change. Their fears were related to nature and animals: “I am afraid of drowning” (14, M); “I am only afraid of snakes” (11, M). Despite a lack of environmental knowledge, these participants expressed appreciation of and happiness concerning nature. “Nature is very beautiful. It can leave a beautiful smile on a person’s face” (7, F).

Actions

Participants in this profile did not report engaging in climate action, but proudly described ensuring the cleanliness of their immediate environment. Teaching children to refrain from dumping garbage in public spaces appeared to be a central role of schools, and children mentioned picking up litter from the beach and planting trees.

Disengaged

Some of the children interviewed could be described as aware of climate change, but not engaged in ecological action. All children in this profile attended private schools and had access to the internet and television. Most of their parents were full-time employees or entrepreneurs working as professional managers or service providers (e.g., airline pilot). When we mentioned that we would give BRL 15.00 to each participant, some said that would not be necessary. We then used the money to buy fruit, which the participants received as a snack during the focus group.

Experience of space

Even though the natural damage occurring in Brazil raises global concerns,1414. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349-57. most the children from this profile thought that climate change occurred in distant places: “It’s a topic that doesn’t interest me, because of the distance, it’s not so close to us” (14, F). Despite the initial perception that climate change happens in a distant place, news about natural disasters in Brazil was beginning to change this perspective for some participants: “I was watching the news about the floods in Minas Gerais, buses that were totally submerged in water, and there were 30 people missing. It was a big shock” (17, F). When climate change directly impacted members of their family, some participants felt proximity to the topic, but this did not necessarily lead to increased engagement with climate action: “When water came into my grandmother’s house, I started to get scared and commented to my family, but nothing too extensive” (15, F).

Experience of time

Participants described discussions around climate change being fleeting rather than something that remains on their minds: “The subject ends quickly. We talk, but we don’t go deep” (18, M).

Emotions

Participants in this profile expressed a sense of indifference, or emotional disengagement: “[Global warming] doesn’t seem very close, it seems a little bit distant, so I’m not too worried” (14, F).

These participants also viewed the topic as ordinary. They attributed their numbness to their continuous exposure to uncomfortable issues: “I never felt any real sadness. I see pollution daily, and garbage on the street. Things like that are so normal here that we end up forgetting about it, so it doesn’t cause such a big impact anymore” (15, M).

Actions

Participants reported taking some simple and convenient actions against climate change, such as recycling and trying to save water, but nothing that involved significantly changing their daily routine. In doing these actions, most of them expressed an optimistic outlook: “It shows that there is still hope for us to fix it” (17, F). Nevertheless, some participants felt powerless to some degree after encountering news about climate change: “I haven’t done anything, there is nothing I can do” (18, M).

Engaged

We found that this profile was mostly composed of children and adolescents whose parents were more engaged in environmental action or were students of private schools that fostered climate awareness as part of their curricula: “My mother is a journalist, so I always know what is going on. My parents have always been very responsible in making me aware of this kind of thing” (12, F). Such children considered climate change to be a problem of the utmost importance. Interestingly, we conducted several interviews in a private school in São Paulo. The coordinator responsible for recruiting the students declined our offer to give BRL 15.00 to each participant because she thought that they did not need this money and should participate out of generosity. Further, for children of this socioeconomic class, BRL 15.00 is an insignificant amount and thus not a meaningful token of appreciation.

Experience of space

Participants in this profile saw climate change as an issue that was [emotionally] close to their hearts and [cognitively] very present in their thoughts: “We are already living through it, so I worry a lot” (13, F). They were self-aware that their urge to distract themselves was an attempt to protect themselves from an unbearable reality: “I’m going to make a pact with the devil so that I can create my own dimension where climate change doesn’t exist” (12, F).

Experience of time

Most children in this profile experienced climate change as a threat to the future of humankind: “Maybe humans will be unable to save nature, and they will end up dying because of it. I fear that maybe trees need a lot longer to grow than they need to fall” (12, F). Some expressed fear that the next generation will be affected: “What if my child has no future?” (11, F). Others even felt that their own lives were in danger: “I don’t know if I will make it past the age of 12” (12, F). The possible absence of a future led to a sense of urgency to act in the present: “I get worried that I might not have a future if we don’t think quickly about what to do” (13, F). Moments of joy shared with friends were experienced as a precarious respite when facing a bleak future: “Soon we won’t be able to live life as well as we do, so we just try to laugh as much as we can, even though it is not the time to laugh” (12, F).

Emotions

Participants in this profile reported different emotions, mostly with negative characteristics, such as anger or anxiety: “I ended up having an anxiety attack, in which I get nervous, I can’t breathe right and it’s weird” (12, F). The perception of climate inaction increased the emotional distress experienced by participants: “How is it that everybody, 100% of people, are not talking about this all the time? It is very alarming. The thing is here, next door” (13, M). For some participants, the anxiety was so great that it disturbed their sleep (“I felt scared, at two in the morning it came to my mind that we could die because of that” [14, M]) or made them want to avoid learning more about climate change (“I’m trying to deny that it exists, we’re trying to protect ourselves and not go crazy” [13, F]). However, some children maintained a degree of optimism and believed that by making the necessary changes, progress could still be made: “Hope is the last thing that dies. Fight until the end to make a difference” (14, M). One participant expressed ambiguous feelings about humanity’s tendency to surpass itself for better or for worse: “I have two totally opposite emotions – sadness that humanity is self-destructing, and I can’t say if it is exactly happiness, but that the whole of humanity has managed to prosper in such a good way, generating new technologies, things that were never imagined” (15, M).

Actions

Most participants of this profile felt pressure to act: “We have to do something more than just classes” (14, M). All participants took concrete actions to reduce their carbon footprint, such as using bicycles instead of cars, reducing meat consumption, saving electricity, recycling, and composting organic waste. One participant referred to an agroforestry owned by their family. (Agroforestry is defined by the U.S. Department of Agriculture as “the intentional integration of trees and shrubs into farming systems to create environmental, economic, and social benefits”). Other participants mentioned planting their own vegetables to reduce their consumption of processed food. Many participants mentioned that their schools encouraged them to take action against climate change: “We had a competition to see who could spend a week using the least energy” (13, M).

Younger children: the development of climate awareness

Thirteen participants in our sample were 5 to 9 years old. This group contained children from different socioeconomic levels, present in the unaware, disengaged, and engaged groups, but with important differences in relation to other older children of these profiles.

Most of them spoke less than the older children during the interviews, but their perceptions of climate change shared some common characteristics. A few younger children from the “unaware” profile knew slightly more about climate change than the older participants. This may illustrate the fact that, in impoverished communities in which most adults have minimal education and where the educational content provided in public schools is limited, any degree of informal education provided by parents produces visible differences in knowledge between peers, independent of their age or grade in school.

Some younger children from families that were very engaged in climate action recalled learning mnemonics at school and at home: “The school talked about the three Rs: recycle, reduce, and reuse” (7, F). In contrast with older children who feared the global consequences of climate change, younger children feared the direct effects on themselves and their families: “I can’t swim well, so we are taking lessons, and we are afraid of flooding” (9, F). They also engaged in environmentally conscious behavior, learning from their parents’ actions: recycling, composting, and avoiding the purchase of unnecessary electronics. One mother in this profile reported that she educated her children by explaining the causes of climate events and emphasizing practical actions, so as to avoid making them feel scared and paralyzed.

How participants described adults

Negative

Some of the participants knew adults who did not believe in climate change, and believed adults were stubborn (“Most adults are all hardheaded, it’s difficult” [14, M]) and less open to changing their minds “because they have already experienced everything, they think [their] mind is already made up” (14, M). This participant also felt that it was the duty of children to teach their parents about climate action: “The children have to influence the parents” (14, M).

Neutral

Parents were also perceived as not critical of climate actions, but also not encouraging. Some even tried committing to climate action, albeit not very successfully: “My mom sometimes decides to stop eating meat, then she goes back [to eating meat]” (15, M). One participant lamented that his parents did not model ecological actions for him: “It’s not that my parents don’t support me, but I think it’s good to have an inspiration. So, if they eat meat, I will eat meat” (15, M).

Positive

Some participants described adults as interested in the subject of climate change: “They are aware and want to know about these things” (12, F). They viewed their parents as reliable sources of information and felt that adults pushed them to learn about climate change: “With adults’ encouragement, it makes you more willing to be aware” (11, F). They also portrayed adults as the ones who could truly influence others and make change: “Adults have more power of speech than children and adolescents, people listen more to them” (13, M), “They can do many things and we can’t, we’re just children” (12, F).

Figure 1 is a graphic summary of the different child and parent profiles.

Figure 1
Youths’ stance on climate change and the adults in their lives.

Discussion

Time and space

The international scientific community has found increasing evidence for the impact of human actions on climate change in the past two decades; despite this, there have been few concrete actions to address the problem, creating what Stoknes1515. Stoknes PE. Rethinking climate communications and the “psychological climate paradox”. Energy Res Soc Sci. 2014;1:161-70. calls the psychological climate paradox. He attributes this phenomenon in part to a lack of effective communication about climate change by the media and educational institutions. One of the main barriers to effective communication described by Stoknes1515. Stoknes PE. Rethinking climate communications and the “psychological climate paradox”. Energy Res Soc Sci. 2014;1:161-70. is portraying climate change as distant, both in time and space. Media depictions of climate change as occurring far in the future or in distant regions of the planet deflate the sense of urgency around climate action.1616. Pahl S, Sheppard S, Boomsma C, Groves C. Perceptions of time in relation to climate change. Wiley Interdiscip Rev Clim Change. 2014;5:375-88. From an evolutionary perspective, humans tend to prioritize short-term threats and immediate cause-and-effect relationships.1616. Pahl S, Sheppard S, Boomsma C, Groves C. Perceptions of time in relation to climate change. Wiley Interdiscip Rev Clim Change. 2014;5:375-88. As a result, the mental images and judgments we form regarding climate change carry less emotional weight and less impetus for action than other subjects that the media frames more prominently.1616. Pahl S, Sheppard S, Boomsma C, Groves C. Perceptions of time in relation to climate change. Wiley Interdiscip Rev Clim Change. 2014;5:375-88.

One recent example of this cognitive bias is the coronavirus disease 2019 (COVID-19) pandemic, when much of the world’s view was of a remote disease that emerged in Asia and spread through Europe. This scenario illustrated the human difficulty to envision a threat that had not yet harmed any person one felt connected to. Lived time and space are not equivalent to factual distances, but to a person’s perceptions. Similarly, personal experience with the consequences of climate change can affect our perception of risk about it.1717. McDonald RI, Chai HY, Newell BR. Personal experience and the ‘psychological distance’ of climate change: An integrative review. J Environ Psychol. 2015;44:109-18. More concrete conceptions of climate change replace our abstract mental models and reduce our psychological distance from it, which in turn can motivate actions to fight climate change.

It is important to note that not everyone experiences time and space in the same way. Young children in our sample – even those who had learned about climate change – focused on its direct impact on their close relatives. Egocentrism, a “state in which thought is centered on the self,” was proposed by psychologist Jean Piaget1818. Piaget J. [Symbolic thought and the thought of the child.]. Arch Psychol. 1923;18:273-304. in 1923, and is typical of preschool-aged children.1919. Babakr ZH, Mohamedamin P, Kakamad K. Piaget’s cognitive developmental theory: critical review. Educ Q Rev. 2019;2:517-24.,2020. Kesselring T, Müller U. The concept of egocentrism in the context of Piaget’s theory. New Ideas Psychol. 2011;29:327-45. Children are limited in their ability for “topological displacement,” meaning a non-dimensioned movement in space and/or time from one’s immediate experience.2121. Householder AS. (Lewin, Kurt. Principles of Topological Psychology. Translated by Fritz and Grace Heider. New York: McGraw-Hill, 1936. p. 231.). Pedagog Semin J Genet Psychol. 1939;54:249-59. This limits their understanding of climate change as a large-scale, networked, and global problem with causes in the past and present as well as indirect consequences in the present and future. It is important to recognize that egocentrism is not a fixed stage, but rather a continuum, which children gradually overcome through interaction with other children,2222. Lourenço O, Machado A. In defense of Piaget’s theory: a reply to 10 common criticisms. Psychol Rev. 1996;103:143-64. imitation, play, role-playing, and language acquisition.2323. Rejeski DW. Children look at nature: environmental perception and education. J Environ Educ. 1982;13:27-40. However, not everyone overcomes egocentrism; depending on the degree of their education and development, many adolescents and even adults maintain largely concrete thinking and focus only on the immediate reality in which they are immersed.1919. Babakr ZH, Mohamedamin P, Kakamad K. Piaget’s cognitive developmental theory: critical review. Educ Q Rev. 2019;2:517-24. In our study, the older children and adolescents from the “disengaged” profile did not feel pressured to act against climate change as long as they did not feel directly affected by it.

As children move through school grades, they begin to develop an ability to conceive of the future as a hypothetical. In this study, children in the engaged profile who were around 11 or 12 demonstrated a capacity for abstraction and imagination of the future, but some painted a rather bleak picture, often bringing up themes of death and destruction of the planet. At this age, a greater openness to the future2424. Messas G. The existential structure of substance misuse: a psychopathological study. Cham: Springer; 2021. may bring increased existential concerns, the most prominent being death anxiety.2525. May R, Yalom ID. Existential psychotherapy. In:Corsini RJ, Wedding D, editors. Current psychotherapies. F E Peacock Publishers; 1989. p. 363-402. In this case, the prospect of damaged ecosystems contributed to a pessimistic view of the future, which resulted in psychological distress.

Social inequality

Our study pointed out important socioeconomic differences between the assessed groups. BRL 15.00 were given to each participant after the interviews; adults in the Ilha de Itaparica community instructed the children to give this money to their parents to buy food or school supplies and reminded them that the money had been given by the researcher, as their parents would be concerned that the children had earned it through illegal activities or from someone untrustworthy. We observed that children in São Paulo did not find much value in this amount. Differences in young people’s perceptions and experiences of climate change are mediated not only by age, but also by social class. It is known that low-income populations contribute less to greenhouse gas emissions2626. World Health Organization. Mental health and climate change: policy brief [Internet]. 2022. https://www.who.int/publications/i/item/9789240045125
https://www.who.int/publications/i/item/...
and yet are more vulnerable to the direct effects of climate change on agriculture and food and water insecurity. These effects exacerbate pre-existing poverty, a well-known risk factor for mental health disorders,2727. Lund C, Breen A, Flisher AJ, Kakuma R, Corrigall J, Joska JA, et al. Poverty and common mental disorders in low and middle income countries: a systematic review. Soc Sci Med. 2010;71:517-28. leading to forced migration and, consequently, reduced access to social services and support networks.2828. Vins H, Bell J, Saha S, Hess JJ. The mental health outcomes of drought: a systematic review and causal process diagram. Int J Environ Res Public Health. 2015;12:13251-75.

The poorest communities suffer from both the natural consequences of climate change and a lack of information on the subject. In our study, participants from poor communities referred to garbage dumping, which is a well-known problem in Brazil, even in coastal areas depending on beach tourism.2929. Souza JL, Silva IR. Avaliação da qualidade ambiental das praias da Ilha de Itaparica, Baía de Todos os Santos, Bahia. Soc Nat. 2015;27:469-83. They had also experienced floods of unprecedented magnitude that affected northeastern Brazil in December 2021.3030. Milhorance F. The New York Times [Internet]. Record floods stun Brazil’s Northeast, killing at least 20. 2021 Dec 28 [cited 2022 Jun 29]. https://www.nytimes.com/2021/12/28/world/americas/brazil-floods-climate-change.html
https://www.nytimes.com/2021/12/28/world...
It is more difficult for poorer communities to access reliable information about climate change,3131. Mtambanengwe F, Mapfumo P, Chikowo R, Chamboko T. Climate change and variability: smallholder farming communities in Zimbabwe portray a varied understanding. Afr Crop Sci J. 2012;20:227-41. which may lead them to experience natural disasters without awareness of their connection with climate change. In our study, we came across children from poor villages who were totally unaware of climate change but spoke about small environmental actions with pride, indicating an inability to assess the limits of their knowledge. Our findings corroborate what Braat3232. Braat C. Dunning-Kruger effect in climate change science communication [Master’s Thesis]. Netherlands: Delft University of Technology; 2020. described regarding the Dunning-Kruger3333. Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77:1121-34. effect: “Individuals incompetent in the field of climate change, compared with their more competent peers, will dramatically overestimate their ability and performance relative to objective criteria.” On the other hand, some participants from wealthier social groups in the disengaged profile mentioned that they would only be indirectly affected by the effects of climate change. Distancing oneself from the issue is a defense mechanism similar to what often occurs in relation to other “uncomfortable” topics, such as social inequalities.3434. Barford A. Emotional responses to world inequality. Emot Space Soc. 2017;22:25-35.

Education for action

One means of communicating more effectively about climate change is harnessing the power of narratives. Stoknes1515. Stoknes PE. Rethinking climate communications and the “psychological climate paradox”. Energy Res Soc Sci. 2014;1:161-70. argues that portraying climate change as an inevitable apocalypse, occurring as a punishment for human actions, only leads to anger, helplessness, fear, guilt, and despair. Instead, portraying the issue as a challenge to be overcome and emphasizing opportunities and hope generates greater engagement.1515. Stoknes PE. Rethinking climate communications and the “psychological climate paradox”. Energy Res Soc Sci. 2014;1:161-70. This is not to say that the unpleasant aspects of climate change should simply be avoided. What captivates a reader of stories is precisely that the most creative solutions emerge from conflicts. This is the idea behind the pedagogy of discomfort, an educational strategy in which participants are pushed beyond their comfort zone regarding some topic, bringing up emotions that cause them to confront their own beliefs, habits, and practices. This leads to self-reflection, opening the way for individual and social transformations.3535. Zembylas M, McGlynn C. Discomforting pedagogies: emotional tensions, ethical dilemmas and transformative possibilities. Br Educ Res J. 2012;38:41-59. The Yerkes-Dodson3636. Broadhurst PL. Emotionality and the Yerkes-Dodson Law. J Exp Psychol. 1957;54:345-52. law also illustrates this idea: it postulates that a state of moderate vigilance and stress can contribute to better performance on challenging tasks.3636. Broadhurst PL. Emotionality and the Yerkes-Dodson Law. J Exp Psychol. 1957;54:345-52. It should be noted that this process needs to be faced in a safe, ethical, and responsible manner that takes into consideration children’s socioeconomic context and the risks involved to their mental health.

Another key element to effective climate change communication in the context of LMICs is language that is accessible to different levels of knowledge and socioeconomic realities. Such communication connects climate change to the daily lives of audiences and seeks to engage them in concrete action. Individuals tend to form risk perceptions that agree with their values, a phenomenon known as the “cultural cognition of risk.”3737. Kahan DM, Jenkins‐Smith H, Braman D. Cultural cognition of scientific consensus. J Risk Res. 2010;14:147-74. Narratives about climate change that speak to universal values can help overcome this bias. Strategies that try to recognize children as part of an interconnected planet and not only of their own country or social context are effective to show that they can act from their place in the world. Schools could promote activities that support the development of empathy towards the self, others, and the planet.3838. Guo L. Preparing teachers to educate for 21st century global citizenship: envisioning and enacting. J Glob Citizsh Equity Educ. 2014;4:1-23. Additionally, collective actions are associated with lower levels of anxiety and negative mental health outcomes3939. Schwartz SEO, Benoit L, Clayton S, Parnes MF, Swenson L, Lowe SR. Climate change anxiety and mental health: Environmental activism as buffer. Curr Psychol. 2022:1-14.; this relationship highlights the importance of encouraging collective actions as a means of creating a sense of participation and agency in the face of climate change. The São Paulo Climate Coalition (Coalizão pelo Clima SP) is a broad organization that brings together collectives and individuals to raise awareness and organize actions to address the climate crisis,4040. Coalizão pelo Clima São Paulo. Medium [Internet]. Há mundo por vir? Manifesto da Coalizão pelo Clima – São Paulo. 2022. https://medium.com/@Contrapoderbr/h%C3%A1-mundo-por-vir-manifesto-da-coaliz%C3%A3o-pelo-clima-s%C3%A3o-paulo-8a3cec5e174e
https://medium.com/@Contrapoderbr/h%C3%A...
while the Solutions Network for Sustainable Development in Amazonia (Rede de Soluções para o Desenvolvimento Sustentável da Amazônia [SDSN Amazônia]), an arm of an international network, has a specific branch for young people with the goal of finding strategies for sustainable development.4141. Sustainable Development Solutions Network. SDSN networks in Action Report [Internet]. 2021 Nov 23. https://resources.unsdsn.org/2021-sdsn-networks-in-action-report
https://resources.unsdsn.org/2021-sdsn-n...
These organizations, along with a number of others, came together to host the III Brazilian Conference on Climate Change (III Conferência Brasileira de Mudança do Clima) in 2021, fostering the proactiveness of Brazilian society in facing the climate crisis.4242. Ferreira LA. O Dia [Internet]. Carta de compromisso ambiental para candidatos nas eleições. 2022 Jun 11 [cited 2022 Jul 8]. https://odia.ig.com.br/colunas/luiz-andre-ferreira/2022/06/6421224-carta-de-compromisso-ambiental-para-candidatos-nas-eleicoes.html
https://odia.ig.com.br/colunas/luiz-andr...

Beyond encouraging collective action, adults can also help children by protecting them from despair and supporting their resilience. Children often have adults as their main role models and mirrors for climate action, and if adults show more environmental self-efficacy, this will enhance children’s abilities to learn and act environmentally.4343. Allen M, Wicks RH, Schulte S. Online environmental engagement among youth: influence of parents, attitudes and demographics. Mass Commun Soc. 2013;16:661-86. As children grow older and enter adolescence, this role migrates to their peers and close friends, as they develop the maturity to translate their attitudes and beliefs into concrete actions.4444. Collado S, Evans GW, Sorrel MA. The role of parents and best friends in children’s pro-environmentalism: Differences according to age and gender. J Environ Psychol. 2017;54:27-37. Adults should empower children to take action, rather than invalidating, diminishing, or ignoring children’s climate concerns as a defense mechanism against guilt about their inaction toward climate change.55. Hickman C, Marks E, Pihkala P, Clayton S, Lewandowski RE, Mayall EE, et al. Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. Lancet Planet Health. 2021;5:e863-73.,4545. Thompson R, Fisher HL, Dewa LH, Hussain T, Kabba Z, Toledano MB. Adolescents’ thoughts and feelings about the local and global environment: a qualitative interview study. Child Adolesc Ment Health. 2022;27:4-13. Another important mistake to be avoided is adultification, in which adults praise children while offloading onto them the responsibility of taking on climate change.55. Hickman C, Marks E, Pihkala P, Clayton S, Lewandowski RE, Mayall EE, et al. Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. Lancet Planet Health. 2021;5:e863-73.

One limitation of this study was our sample, recruited in only two geographical areas (states of São Paulo and Bahia) of a country that is geographically, socially, economically, and culturally diverse. Additionally, we did not encounter participants of lower socioeconomic background who were engaged in climate change. This absence does not mean young people of this socioeconomic class do not exist, as many have been observed participating in social and political movements with environmental themes, such as the Black Brazilian movement, which took agendas on climate racism to the COP26, a World Health Organization Conference about climate change.4646. Fillipe M. Exame [Internet]. Racismo climático: movimento negro brasileiro leva pauta para a COP26. Exame. 2021 Nov 1 [cited 2022 Jul 8]. https://exame.com/negocios/racismo-climatico-movimento-negro-brasileiro-leva-pauta-para-a-cop26/
https://exame.com/negocios/racismo-clima...
Future studies could include Brazilian children from relevant minority groups, such as the indigenous population or riverine and rural inhabitants – populations whose cultures have historically been linked to nature and affected by climate change, which could provide interesting insights on the subject.

Understanding children’s and adolescents’ subjective experiences is a crucial step to creating effective communication strategies for climate education and helping them manage their feelings of anxiety and distress around climate change. Their perception of time and space directly impacts the emotions they will experience and their level of engagement in climate action. In the context of LMICs, different perceptions may reflect children’s socioeconomic characteristics, educational level, and level of development. Therefore, narratives on climate action should be multiple and address the different realities experienced by these children, so as to empower them to act locally as global citizens.

Acknowledgements

This research was supported by the Fulbright Visiting Scholar Program (LB), by the Monahan Foundation through an award for medical research (LB), and through the generosity of the Fondation Jasmin Roy Sophie Desmarais (LB) and the Riva Ariella Ritvo Endowment at the Yale School of Medicine (AM). Instituto de Psiquiatria, Universidade de São Paulo, supported this research through visiting scholar grants for DTC and EAN.

References

  • 1
    World Health Organization (WHO). Checklists to assess vulnerabilities in health care facilities in the context of climate change [Internet]. 2021 [cited 2022 June 29]. https://www.who.int/publications-detail-redirect/9789240022904
    » https://www.who.int/publications-detail-redirect/9789240022904
  • 2
    Crandon TJ, Scott JG, Charlson FJ, Thomas HJ. A social-ecological perspective on climate anxiety in children and adolescents. Nat Clim Change. 2022;12:123-31.
  • 3
    Albrecht G. Chronic environmental change: emerging ‘psychoterratic’ syndromes. In: Weissbecker I, editor. Climate change and human well-being. New York: Springer; 2011. p. 43-56.
  • 4
    Clayton S, Manning C, Speiser M, Hill AN. Mental health and our changing climate: impacts, inequities, responses [Internet]. 2021. https://www.apa.org/news/press/releases/mental-health-climate-change.pdf
    » https://www.apa.org/news/press/releases/mental-health-climate-change.pdf
  • 5
    Hickman C, Marks E, Pihkala P, Clayton S, Lewandowski RE, Mayall EE, et al. Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. Lancet Planet Health. 2021;5:e863-73.
  • 6
    Stoknes PE. What we think about when we try not to think about global warming: toward a new psychology of climate action. Vermont: Chelsea Green Publishing; 2015.
  • 7
    Benoit L, Thomas I, Martin A. Review: Ecological awareness, anxiety, and actions among youth and their parents – a qualitative study of newspaper narratives. Child Adolesc Ment Health. 2022;27:47-58.
  • 8
    Instituto Brasileiro de Geografia e Estatística. Panorama dos estados – Bahia [Internet]. 2017. https://cidades.ibge.gov.br/brasil/ba/panorama
    » https://cidades.ibge.gov.br/brasil/ba/panorama
  • 9
    Bretas V. Exame [Internet] Os estados mais violentos do Brasil. 2017 Nov 04. https://exame.com/brasil/os-estados-mais-violentos-do-brasil-3/
    » https://exame.com/brasil/os-estados-mais-violentos-do-brasil-3/
  • 10
    Instituto Brasileiro de Geografia e Estatística. Panorama das cidades – Itaparica. 2022. https://cidades.ibge.gov.br/brasil/ba/itaparica/panorama
    » https://cidades.ibge.gov.br/brasil/ba/itaparica/panorama
  • 11
    United Nations Educational, Scientific and Cultural Organization (UNESCO). Historic centre of Salvador de Bahia. 2022. https://whc.unesco.org/en/list/309/
    » https://whc.unesco.org/en/list/309/
  • 12
    Smith JA, Osborn M. Interpretative phenomenological analysis as a useful methodology for research on the lived experience of pain. Br J Pain. 2015;9:41-2.
  • 13
    Engward H, Goldspink S. Lodgers in the house: living with the data in interpretive phenomenological analysis research. Reflective Pract. 2020;21:41-53.
  • 14
    Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349-57.
  • 15
    Stoknes PE. Rethinking climate communications and the “psychological climate paradox”. Energy Res Soc Sci. 2014;1:161-70.
  • 16
    Pahl S, Sheppard S, Boomsma C, Groves C. Perceptions of time in relation to climate change. Wiley Interdiscip Rev Clim Change. 2014;5:375-88.
  • 17
    McDonald RI, Chai HY, Newell BR. Personal experience and the ‘psychological distance’ of climate change: An integrative review. J Environ Psychol. 2015;44:109-18.
  • 18
    Piaget J. [Symbolic thought and the thought of the child.]. Arch Psychol. 1923;18:273-304.
  • 19
    Babakr ZH, Mohamedamin P, Kakamad K. Piaget’s cognitive developmental theory: critical review. Educ Q Rev. 2019;2:517-24.
  • 20
    Kesselring T, Müller U. The concept of egocentrism in the context of Piaget’s theory. New Ideas Psychol. 2011;29:327-45.
  • 21
    Householder AS. (Lewin, Kurt. Principles of Topological Psychology. Translated by Fritz and Grace Heider. New York: McGraw-Hill, 1936. p. 231.). Pedagog Semin J Genet Psychol. 1939;54:249-59.
  • 22
    Lourenço O, Machado A. In defense of Piaget’s theory: a reply to 10 common criticisms. Psychol Rev. 1996;103:143-64.
  • 23
    Rejeski DW. Children look at nature: environmental perception and education. J Environ Educ. 1982;13:27-40.
  • 24
    Messas G. The existential structure of substance misuse: a psychopathological study. Cham: Springer; 2021.
  • 25
    May R, Yalom ID. Existential psychotherapy. In:Corsini RJ, Wedding D, editors. Current psychotherapies. F E Peacock Publishers; 1989. p. 363-402.
  • 26
    World Health Organization. Mental health and climate change: policy brief [Internet]. 2022. https://www.who.int/publications/i/item/9789240045125
    » https://www.who.int/publications/i/item/9789240045125
  • 27
    Lund C, Breen A, Flisher AJ, Kakuma R, Corrigall J, Joska JA, et al. Poverty and common mental disorders in low and middle income countries: a systematic review. Soc Sci Med. 2010;71:517-28.
  • 28
    Vins H, Bell J, Saha S, Hess JJ. The mental health outcomes of drought: a systematic review and causal process diagram. Int J Environ Res Public Health. 2015;12:13251-75.
  • 29
    Souza JL, Silva IR. Avaliação da qualidade ambiental das praias da Ilha de Itaparica, Baía de Todos os Santos, Bahia. Soc Nat. 2015;27:469-83.
  • 30
    Milhorance F. The New York Times [Internet]. Record floods stun Brazil’s Northeast, killing at least 20. 2021 Dec 28 [cited 2022 Jun 29]. https://www.nytimes.com/2021/12/28/world/americas/brazil-floods-climate-change.html
    » https://www.nytimes.com/2021/12/28/world/americas/brazil-floods-climate-change.html
  • 31
    Mtambanengwe F, Mapfumo P, Chikowo R, Chamboko T. Climate change and variability: smallholder farming communities in Zimbabwe portray a varied understanding. Afr Crop Sci J. 2012;20:227-41.
  • 32
    Braat C. Dunning-Kruger effect in climate change science communication [Master’s Thesis]. Netherlands: Delft University of Technology; 2020.
  • 33
    Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77:1121-34.
  • 34
    Barford A. Emotional responses to world inequality. Emot Space Soc. 2017;22:25-35.
  • 35
    Zembylas M, McGlynn C. Discomforting pedagogies: emotional tensions, ethical dilemmas and transformative possibilities. Br Educ Res J. 2012;38:41-59.
  • 36
    Broadhurst PL. Emotionality and the Yerkes-Dodson Law. J Exp Psychol. 1957;54:345-52.
  • 37
    Kahan DM, Jenkins‐Smith H, Braman D. Cultural cognition of scientific consensus. J Risk Res. 2010;14:147-74.
  • 38
    Guo L. Preparing teachers to educate for 21st century global citizenship: envisioning and enacting. J Glob Citizsh Equity Educ. 2014;4:1-23.
  • 39
    Schwartz SEO, Benoit L, Clayton S, Parnes MF, Swenson L, Lowe SR. Climate change anxiety and mental health: Environmental activism as buffer. Curr Psychol. 2022:1-14.
  • 40
    Coalizão pelo Clima São Paulo. Medium [Internet]. Há mundo por vir? Manifesto da Coalizão pelo Clima – São Paulo. 2022. https://medium.com/@Contrapoderbr/h%C3%A1-mundo-por-vir-manifesto-da-coaliz%C3%A3o-pelo-clima-s%C3%A3o-paulo-8a3cec5e174e
    » https://medium.com/@Contrapoderbr/h%C3%A1-mundo-por-vir-manifesto-da-coaliz%C3%A3o-pelo-clima-s%C3%A3o-paulo-8a3cec5e174e
  • 41
    Sustainable Development Solutions Network. SDSN networks in Action Report [Internet]. 2021 Nov 23. https://resources.unsdsn.org/2021-sdsn-networks-in-action-report
    » https://resources.unsdsn.org/2021-sdsn-networks-in-action-report
  • 42
    Ferreira LA. O Dia [Internet]. Carta de compromisso ambiental para candidatos nas eleições. 2022 Jun 11 [cited 2022 Jul 8]. https://odia.ig.com.br/colunas/luiz-andre-ferreira/2022/06/6421224-carta-de-compromisso-ambiental-para-candidatos-nas-eleicoes.html
    » https://odia.ig.com.br/colunas/luiz-andre-ferreira/2022/06/6421224-carta-de-compromisso-ambiental-para-candidatos-nas-eleicoes.html
  • 43
    Allen M, Wicks RH, Schulte S. Online environmental engagement among youth: influence of parents, attitudes and demographics. Mass Commun Soc. 2013;16:661-86.
  • 44
    Collado S, Evans GW, Sorrel MA. The role of parents and best friends in children’s pro-environmentalism: Differences according to age and gender. J Environ Psychol. 2017;54:27-37.
  • 45
    Thompson R, Fisher HL, Dewa LH, Hussain T, Kabba Z, Toledano MB. Adolescents’ thoughts and feelings about the local and global environment: a qualitative interview study. Child Adolesc Ment Health. 2022;27:4-13.
  • 46
    Fillipe M. Exame [Internet]. Racismo climático: movimento negro brasileiro leva pauta para a COP26. Exame. 2021 Nov 1 [cited 2022 Jul 8]. https://exame.com/negocios/racismo-climatico-movimento-negro-brasileiro-leva-pauta-para-a-cop26/
    » https://exame.com/negocios/racismo-climatico-movimento-negro-brasileiro-leva-pauta-para-a-cop26/

Publication Dates

  • Publication in this collection
    03 July 2023
  • Date of issue
    May-Jun 2023

History

  • Received
    03 Oct 2022
  • Accepted
    13 Mar 2023
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