Digital Methods for the Spiritual and Mental Health of Generation Z: Scoping Review.

BACKGROUND: Generation Z (Gen Z) includes individuals born between 1995 and 2012. These individuals experience high rates of anxiety and depression. Most Gen Z individuals identify with being spiritual, and aspects from religion and spirituality can be integrated into mental health treatment and care as both are related to lower levels of depression. However, research on the spiritual and mental health of Gen Z is sparse. To date, there are no systematic or scoping reviews on digital methods to address the spiritual and mental health of Gen Z. OBJECTIVE: This scoping review aimed to describe the current state of digital methods to address spiritual and mental health among Gen Z, identify the knowledge gaps, and make suggestions for how to leverage digital spiritual and mental health interventions for Gen Z. METHODS: A comprehensive literature search was conducted in PubMed, Scopus, PsycInfo, CINAHL, Education Full Text, Google Scholar, SocIndex, and Sociological Abstracts. The inclusion criteria were as follows: (1) study population born between 1995 and 2012 (ie, Gen Z); (2) reporting on spiritual health or well-being, spirituality or religion, and mental health or well-being; (3) reporting on using digital methods; (4) publication in 1996 or beyond; (5) human subject research; (6) full text availability in English; (7) primary research study design; and (8) peer-reviewed article. Two authors screened articles and subsequently extracted data from the included articles to describe the available evidence. RESULTS: A total of 413 articles were screened at the title and abstract levels, of which 27 were further assessed with full text for eligibility. Five studies met the inclusion criteria, and data were extracted to summarize study characteristics and findings. The studies were performed across 4 different countries. There were 2 mixed-methods studies (South Africa and Canada), 2 cross-sectional studies (China and United States), and 1 randomized controlled trial (United States). Of these studies, only 2 discussed digital interventions (a text messaging-based intervention to improve spiritual and mental health, and a feasibility study for a mental health app). Other studies had a digital component with minor or unclear spiritual and mental health measures. Overall, there was a lack of consistency in how spiritual and mental health were measured. CONCLUSIONS: Few studies have focused on assessing the spiritual and mental health of Gen Z in the digital context, and no research to date has examined a digital spiritual and mental health application among Gen Z. Research is needed to inform the development and evaluation of approaches to address the spiritual and mental health of Gen Z via digital means (eg, mobile apps).

Exploring Generation Z and Young Millennials' Perspectives of a Spiritual Self-Care App and Their Spiritual Identity (Skylight): Qualitative Semistructured Interview Study.

BACKGROUND: Generation Z and young millennials (ages 18-35 years), collectively referred to as GenZennials, are connected to technology and the internet like no other generation before them. This has mental health implications, such as increased rates of anxiety and stress. Recent research has shown that app-based mental health interventions can be useful to address such mental health concerns. However, spirituality is an untapped resource, especially since GenZennials largely identify as spiritual and already integrate spiritual practices into their self-care. OBJECTIVE: There were four objectives to this study: (1) comprehensively explore reasons why GenZennials use a spiritual self-care app (ie, Skylight; Radiant Foundation), (2) understand how GenZennials identify spiritually, (3) understand the app's relevance to GenZennials, and (4) gather feedback and suggestions to improve the app. METHODS: Semistructured interviews were conducted with 23 GenZennials (ages 18-35 years; mean 28.7, SD 5.0 years; n=20, 87% female) who used the Skylight app. Interviews were 30 to 60 minutes and conducted on Zoom. Thematic analysis was used to analyze interviews. RESULTS: Five major categories emerged from the analysis, each encompassing one to several themes: (1) reasons for using the Skylight app, (2) content favorites, (3) defining spiritual identity, (4) relevance to GenZennials, and (5) overall improvement recommendations. Participants used the app for various reasons including to relax, escape, or ground themselves; improve mood; and enhance overall health and wellness. Participants also cited the app's variety of content offerings and its free accessibility as their primary reasons for using it. Most participants identified themselves as solely spiritual (8/23/35%) among the options provided (ie, spiritual or religious or both), and they appreciated the app's inclusive content. Participants felt that the app was relevant to their generation as it offered modern content (eg, spiritual self-care activities and short content). Participants recommended adding more personalization capabilities, content, and representation to the app. CONCLUSIONS: This is the first study to qualitatively explore GenZennials' perspectives and the use of a spiritual self-care app. Our findings should inform the future creation and improvement of spiritual self-care apps aimed at cultivating GenZennials' spiritual and mental well-being. Future research is warranted to examine the effects of using a spiritual self-care app on GenZennial mental health.

A Spiritual Self-Care Mobile App (Skylight) for Mental Health, Sleep, and Spiritual Well-Being Among Generation Z and Young Millennials: Cross-Sectional Survey.

BACKGROUND: Generation Z (Gen Z) and young millennials (GenZennials) (ages 18-35 years) are unique in that they either have no memory of or were born shortly after the internet "explosion." They are constantly on the internet, face significant challenges with their mental health and sleep, and are frequent users of digital wellness apps. GenZennials also uniquely identify with and practice spirituality, which has been linked to better mental health and sleep in adult populations. Research has not examined digital approaches to spiritual self-care and its relationship to mental health and sleep in GenZennials. OBJECTIVE: The purpose of this study was to describe a sample of adult GenZennials who use a spiritual self-care app (ie, Skylight), describe how users engage with and perceive the app, and assess the relationship between frequency of using the app with mental health, sleep, and spiritual well-being. METHODS: Participants were 475 adult Gen Z (ages 18-28 years) and young millennial (ages 29-35 years) Skylight app users who responded to an anonymous survey on the web. The survey asked about demographics, spiritual self-care and practice, and user engagement and perceptions of the app. Outcome measures included 4 validated surveys for mental health (ie, depression, anxiety, and stress) and sleep disturbance, and one validated survey on spiritual well-being. Mean scores were calculated for all measures, and linear regressions were conducted to examine the relationship between the frequency of app use and mental health, sleep, and spiritual well-being outcomes. RESULTS: Participants were predominantly White (324/475, 68.2%) and female (255/475, 53.7%), and approximately half Gen Z (260/475, 54.5%) and half young millennials (215/475, 45.3%). Most users engaged in spiritual self-care (399/475, 84%) and said it was important or very important to them (437/475, 92%). Users downloaded the app for spiritual well-being (130/475, 30%) and overall health (125/475, 26.3%). Users had normal, average depressive symptoms (6.9/21), borderline abnormal anxiety levels (7.7/21), slightly elevated stress (6.7/16), and nonclinically significant sleep disturbance (5.3/28). Frequency of app use was significantly associated with lower anxiety (Moderate use: ß=-2.01; P=.02; high use: ß=-2.58; P<.001). There were no significant relationships between the frequency of app use and mental health, sleep, and spiritual well-being outcomes except for the personal domain of spiritual well-being. CONCLUSIONS: This is the first study to describe a sample of adult GenZennials who use a spiritual self-care app and examine how the frequency of app use is related to their mental health, sleep, and spiritual well-being. Spiritual self-care apps like Skylight may be useful in addressing anxiety among GenZennials and be a resource to spiritually connect to their personal spiritual well-being. Future research is needed to determine how a spiritual self-care app may benefit mental health, sleep, and spiritual well-being in adult GenZennials.

Technology Use During the COVID-19 Pandemic and the Ways in Which Technology Can Support Adolescent Well-being: Qualitative Exploratory Study.

BACKGROUND: Most adolescents in the United States engage with technology. Social isolation and disruptions in activities owing to the COVID-19 pandemic have been linked to worsening mood and overall decreased well-being in adolescents. Although studies on the direct impacts of technology on adolescent well-being and mental health are inconclusive, there are both positive and negative associations depending on various factors, such as how the technology is used and by whom under certain settings. OBJECTIVE: This study applied a strengths-based approach and focused on the potential to leverage technology to benefit adolescent well-being during a public health emergency. This study aimed to gain an initial and nuanced understanding of how adolescents have used technology to support their wellness throughout the pandemic. In addition, this study aimed to further motivate future large-scale research on how technology can be leveraged to benefit adolescent well-being. METHODS: This study used an exploratory qualitative approach and was conducted in 2 phases. Phase 1 consisted of interviewing subject matter experts who work with adolescents to inform the creation of a semistructured interview for phase 2. Subject matter experts were recruited from existing connections with the Hemera Foundation and National Mental Health Innovation Center's (NMHIC) networks. In phase 2, adolescents (aged 14-18 years) were recruited nationally through social media (eg, Facebook, Twitter, LinkedIn, and Instagram) and via email to institutions (eg, high schools, hospitals, and health technology companies). High school and early college interns at NMHIC led the interviews via Zoom (Zoom Video Communications) with an NMHIC staff member on the call in an observational role. A total of 50 adolescents completed interviews regarding their technology use and its role during the COVID-19 pandemic. RESULTS: The overarching themes identified from the data were COVID-19's impact on adolescent lives, positive role of technology, negative role of technology, and resiliency. Adolescents engaged with technology as a way to foster and maintain connection in a time of extended isolation. However, they also demonstrated an awareness of when technology was negatively affecting their well-being, prompting them to turn to other fulfilling activities that do not involve technology. CONCLUSIONS: This study highlights how adolescents have used technology for well-being throughout the COVID-19 pandemic. Guidelines based on insights from the results of this study were created for adolescents, parents, caregivers, and teachers to provide recommendations for how adolescents can use technology to bolster overall well-being. Adolescents' ability to recognize when they need to engage in nontechnology-related activities and their ability to use technology to reach a larger community indicate that technology can be facilitated in positive ways to benefit their overall well-being. Future research should focus on increasing the generalizability of recommendations and identifying additional ways to leverage mental health technologies.

A Framework for the Implementation of Digital Mental Health Interventions: The Importance of Feasibility and Acceptability Research.

Digital mental health interventions (DMHIs) have the potential to serve a significantly wider portion of the population in need of mental health services. The coronavirus disease 2019 (COVID-19) pandemic has especially highlighted the exacerbation of mental health disparities among minoritized populations. Innovations and research on DMHIs continue to expand, reinforcing the need for a more systemic process of DMHI implementation. In practice, DMHI implementation often skips the fundamental steps of conducting acceptability and feasibility studies. We propose a DMHI implementation framework that identifies an acceptability and feasibility study as an essential first step, simultaneously centering equitable processes that address populations disproportionately affected by mental illness.