{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:25:40Z","timestamp":1790187940238,"version":"4.1.0"},"reference-count":46,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Climate change and mental health research has predominantly focused on adults in non-clinical settings; investigations among youth and in clinical settings are lacking. Our objectives were to understand the relationship between adult caregiver and adolescent patient climate-anxiety and to examine caregivers\u2019 community-level concerns and their association with adolescent climate anxiety. This cross-sectional study occurred in a single-center pediatric emergency department (ED) and data collection spanned January to December 2024. Exposures included adolescent demographic factors (age group, sex, race and ethnicity, insurance payor) and adolescent and caregiver general anxiety disorder-7 (GAD-7) scores, as well as caregiver perspectives captured on (1) the climate change anxiety scale (CCAS), (2) a domestic and global issues poll, and (3) an environmental community survey. The outcome was adolescent climate anxiety, operationalized using the CCAS.\u2009In total, 557 patient-caregiver dyads completed CCAS surveys, with low within-dyad agreement in scores, ICC\u2009=\u20090.224 (95% CI 0.142, 0.274). Both caregivers and adolescents had higher levels of climate anxiety if the caregiver reported concerns about housing, public services, and pollution in their community (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.05). Moderate-severe generalized anxiety (GAD-7) was the strongest predictor of climate anxiety in both adolescents and caregivers (OR\n                    <jats:sub>adj<\/jats:sub>\n                    6.59, 95% CI 3.52-12.30,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001). Caregivers viewing climate change as very important had higher odds of moderate-severe CCAS (OR\n                    <jats:sub>adj<\/jats:sub>\n                    \u2009=\u20094.50 (95% CI 2.03, 9.98),\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001), with no significant effect of their perception on adolescent CCAS (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.172).\u2009Generalized anxiety and adult caregiver community-level concerns appear to be associated with adolescent climate anxiety in this large pediatric study, but there is no direct relationship between caregiver climate anxiety and the climate anxiety of the adolescent.\n                  <\/jats:p>","DOI":"10.1177\/00469580251411470","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T10:17:26Z","timestamp":1767953846000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["An Adolescent-Caregiver Dyad Approach to Climate Anxiety in the Pediatric Emergency Department"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4326-0059","authenticated-orcid":false,"given":"Raymen R.","family":"Assaf","sequence":"first","affiliation":[{"name":"Children\u2019s Hospital, Orange County, CA, USA"},{"name":"University of California, Irvine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby K.","family":"Shelton","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, Orange County, CA, USA"},{"name":"CHOC Research Institute, Orange, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tricia","family":"Morphew","sequence":"additional","affiliation":[{"name":"CHOC Research Institute, Orange, CA, USA"},{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Clayton","sequence":"additional","affiliation":[{"name":"The College of Wooster, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Wu","sequence":"additional","affiliation":[{"name":"University of California, Irvine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"UCLA Center for the Developing Adolescent. The opportunities and effects of climate action on adolescents. University of California Los Angeles. Published April 28 2025. Accessed October 18 2025. https:\/\/developingadolescent.semel.ucla.edu\/blog\/item\/the-opportunities-and-effects-of-climate-action-on-adolescents"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(24)00229-8"},{"key":"e_1_3_4_4_2","unstructured":"Ndugga N Artiga S. Climate change and health equity: key questions and answers. KFF. Published May 24 2022. Accessed April 16 2025. https:\/\/www.kff.org\/racial-equity-and-health-policy\/issue-brief\/climate-change-and-health-equity-key-questions-and-answers\/"},{"key":"e_1_3_4_5_2","unstructured":"Climate Psychology Alliance. The handbook of climate psychology. Climate Psychology Alliance. Published August 29 2022. Accessed August 15 2025. https:\/\/www.climatepsychologyalliance.org\/index.php\/component\/content\/article\/climate-psychology-handbook?catid=15&Itemid=101"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/inm.13201"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-021-02099-3"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.14035"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-024-01746-1"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-025-00872-x"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.14.04061"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(21)00278-3"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/jad.12455"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.pn.2024.07.7.37"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.872544"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jenvp.2020.101434"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10584-021-03234-6"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-024-02240-4"},{"key":"e_1_3_4_19_2","unstructured":"Navarro-Carrillo G Torres-Marin J Moya-Garofano A. Psychometric evaluation of the Spanish adaptation of the Climate change anxiety scale. PsyEcology. 2025. Accessed August 14 2025. https:\/\/www.researchgate.net\/publication\/385972255_Psychometric_Evaluation_of_the_Spanish_Adaptation_of_the_Climate_Change_Anxiety_Scale"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318160d093"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.03.047"},{"key":"e_1_3_4_23_2","unstructured":"The Washington Post. Washington post-Kaiser family foundation climate change survey July 9-August 5 2019. Climate and Environment. Updated December 9 2019. Accessed September 9 2023. https:\/\/www.washingtonpost.com\/context\/washington-post-kaiser-family-foundation-climate-change-survey-july-9-aug-5-2019\/601ed8ff-a7c6-4839-b57e-3f5eaa8ed09f\/"},{"key":"e_1_3_4_24_2","unstructured":"Alameda County Community Development Agency. Alameda County: environmental justice element. Published August 2024. Accessed September 2024. https:\/\/www.acgov.org\/cda\/planning\/generalplans\/documents\/EJElement_adoptedAug2024.pdf"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-3169"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-021-01436-z"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4793-7"},{"key":"e_1_3_4_28_2","unstructured":"Orvis K. OMB publishes revisions to statistical policy directive no.15: standards for maintaining collecting and presenting federal data on race and ethnicity. The White House. Published March 28 2024. Accessed December 3 2024. https:\/\/www.whitehouse.gov\/omb\/briefing-room\/2024\/03\/28\/omb-publishes-revisions-to-statistical-policy-directive-no-15-standards-for-maintaining-collecting-and-presenting-federal-data-on-race-and-ethnicity\/"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjb.2021.18"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-environ-012220-022716"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/camh.12525"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0023141"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20065064"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-024-06274-1"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-021-01385-4"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40572-020-00303-3"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2018.07.898"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1017\/9781009252904.012"},{"key":"e_1_3_4_39_2","unstructured":"American Psychological Association. Stress in America: Generation Z. Published 2018. Accessed August 18 2025. https:\/\/www.apa.org\/news\/press\/releases\/stress\/2018\/stress-gen-z.pdf"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1080\/17405629.2022.2108396"},{"key":"e_1_3_4_41_2","volume-title":"Theories of Adolescence","author":"Goossens L","year":"2007","unstructured":"Goossens L, ed. Theories of Adolescence. 1st ed. Psychology Press; 2007.","edition":"1"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1002233"},{"key":"e_1_3_4_43_2","unstructured":"Strauss Cohen I. Understanding Bowen family systems theory. Psychology Today. Published November 13 2023. Accessed August 20 2025. https:\/\/www.psychologytoday.com\/us\/blog\/your-emotional-meter\/202311\/understanding-bowen-family-systems-theory#:~:text=%E2%80%8B%E2%80%8B%E2%80%8B%E2%80%8B%E2%80%8B with%20greater%20clarity%20and%20resilience"},{"key":"e_1_3_4_44_2","article-title":"The effect of social media influencers on teenagers\u2019 behavior: an empirical study using cognitive map technique","author":"Lajnef K.","unstructured":"Lajnef K. The effect of social media influencers on teenagers\u2019 behavior: an empirical study using cognitive map technique. Curr Psychol. Published online January 31, 2023. doi: 10.1007\/s12144-023-04273-1","journal-title":"Curr Psychol"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-065505"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41560-020-00763-9"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb2213250"}],"container-title":["INQUIRY: The Journal of Health Care Organization, Provision, and Financing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00469580251411470","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00469580251411470","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00469580251411470","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:11:01Z","timestamp":1777461061000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00469580251411470"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":46,"alternative-id":["10.1177\/00469580251411470"],"URL":"https:\/\/doi.org\/10.1177\/00469580251411470","relation":{},"ISSN":["0046-9580","1945-7243"],"issn-type":[{"value":"0046-9580","type":"print"},{"value":"1945-7243","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"00469580251411470"}}