Estimating climate change and mental health impacts in Canada: A cross-sectional survey protocol

STUDY PROTOCOL Estimating climate change and mental health impacts in Canada: A cross-sectional survey protocol Sherilee L. HarperID1*, Ashlee CunsoloID2, Breanne Aylward1, Susan Clayton3, Kelton Minor4, Madison Cooper1, Rachael Vriezen1 1 School of Public Health, University of Alberta, Edmonton, Canada, 2 School of Arctic & Subarctic Studies, Labrador Campus of Memorial University, Happy Valley-Goose Bay, Canada, 3 College of Wooster, Wooster, Ohio, United States of America, 4 Data Science Institute, Columbia University, New York, New York, United States of America * sherilee@ualberta.ca, sherilee.harper@ualberta.ca Abstract Climate change has severe and sweeping impacts on mental health. Although research is burgeoning on mental health impacts following climate and weather extremes, less is known about how common these impacts are outside of extreme events. Existing research explor- ing the prevalence of psychosocial responses to climate change primarily examines univer- sity students and uses non-random sampling methods. Herein, our protocol outlines an approach to data collection, processing, and analysis to estimate the population prevalence, magnitude, and distribution of mental health responses to climate change in Canada. A cross-sectional survey of youth and adults aged 13 years and older in Canada will be admin- istered over the course of one year. The questionnaire will take approximately 10 minutes to complete orally and will be administered in English, French, and Inuktitut. The survey will

consist of six sections: (1) self-reported past experiences of climate change; (2) self- reported climate-related emotions; (3) self-reported past and current impacts, anticipatory impacts, and vicarious experiences; (4) self-reported subclinical outcomes; (5) self-reported behavioural responses; and (6) demographics. A multi-stage, multi-stratified random proba- bility sampling method will be used to obtain a sample representative of the Canadian popu- lation. We will use two different modes of recruitment: an addressed letter sent by postal mail or a telephone call (landlines and cellular). Population-weighted descriptive statistics, principal component analysis, and weighted multivariable regression will be used to analyse the data. The results of this survey will provide the first national prevalence estimates of sub- clinical mental health responses to climate change outcomes of people living in Canada. Introduction Given the mounting evidence, it is undeniable that climate change affects our mental health and wellness [1]. Directly experiencing slow-onset climate changes (e.g. sea level rise, ocean acidification, permafrost thaw) and/or weather and climate extremes (e.g. wildfires, flooding, PLOS ONE PLOS ONE | https://doi.org/10.1371/journal.pone.0291303 October 11, 2023 1 / 12 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Harper SL, Cunsolo A, Aylward B, Clayton S, Minor K, Cooper M, et al. (2023) Estimating climate change and mental health impacts in Canada: A cross-sectional survey protocol. PLoS

ONE 18(10): e0291303. https://doi.org/10.1371/ journal.pone.0291303 Editor: Ulysses Paulino Albuquerque, Universidade Federal de Pernambuco, BRAZIL Received: April 6, 2023 Accepted: August 22, 2023 Published: October 11, 2023 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0291303 Copyright: © 2023 Harper et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: N/A - No results are reported. This is a protocol paper, so there are no data associated with this paper.