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Park SY, Yourell J, McAlister KL, Huberty J. Exploring Generation Z and Young Millennials' Perspectives of a Spiritual Self-Care App and Their Spiritual Identity (Skylight): Qualitative Semistructured Interview Study. JMIR Form Res 2023; 7:e54284. [PMID: 38064199 PMCID: PMC10784987 DOI: 10.2196/54284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023] Open
Abstract
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.
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Affiliation(s)
- Susanna Y Park
- Skylight, Radiant Foundation, Salt Lake City, UT, United States
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Park SY, Huberty J, Yourell J, McAlister KL, Beatty CC. A Spiritual Self-Care Mobile App (Skylight) for Mental Health, Sleep, and Spiritual Well-Being Among Generation Z and Young Millennials: Cross-Sectional Survey. JMIR Form Res 2023; 7:e50239. [PMID: 37597179 PMCID: PMC10568400 DOI: 10.2196/50239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/02/2023] [Accepted: 08/19/2023] [Indexed: 08/21/2023] Open
Abstract
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: β=-2.01; P=.02; high use: β=-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.
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Affiliation(s)
- Susanna Y Park
- Skylight, Radiant Foundation, Salt Lake City, UT, United States
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McAlister KL, Mack WJ, Bir C, Baron DA, Som C, Li K, Chavarria-Garcia A, Sawardekar S, Baron D, Toth Z, Allem C, Beatty N, Nakayama J, Kelln R, Zaslow T, Bansal R, Peterson BS. Longitudinal, prospective study of head impacts in male high school football players. PLoS One 2023; 18:e0291374. [PMID: 37682984 PMCID: PMC10490840 DOI: 10.1371/journal.pone.0291374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION Repetitive, subconcussive events may adversely affect the brain and cognition during sensitive periods of development. Prevention of neurocognitive consequences of concussion in high school football is therefore an important public health priority. We aimed to identify the player positions and demographic, behavioral, cognitive, and impact characteristics that predict the frequency and acceleration of head impacts in high school football players. METHODS In this prospective study, three cohorts of adolescent male athletes (N = 53, 28.3% Hispanic) were recruited over three successive seasons in a high school American football program. Demographic and cognitive functioning were assessed at baseline prior to participating in football. Helmet sensors recorded impact frequency and acceleration. Each head impact was captured on film from five different angles. Research staff verified and characterized on-field impacts. Player-level Poisson regressions and year-level and impact-level linear mixed-effect models were used to determine demographic, behavioral, cognitive, and impact characteristics as predictors of impact frequency and acceleration. RESULTS 4,678 valid impacts were recorded. Impact frequency positively associated with baseline symptoms of hyperactivity-impulsivity [β(SE) = 1.05 impacts per year per unit of symptom severity (1.00), p = 0.01] and inattentiveness [β(SE) = 1.003 impacts per year per T-score unit (1.001), p = 0.01]. Compared to quarterbacks, the highest acceleration impacts were sustained by kickers/punters [β(SE) = 21.5 g's higher (7.1), p = 0.002], kick/punt returners [β(SE) = 9.3 g's higher (4.4), p = 0.03], and defensive backs [β(SE) = 4.9 g's higher (2.5), p = 0.05]. Impacts were more frequent in the second [β(SE) = 33.4 impacts (14.2), p = 0.02)] and third [β(SE) = 50.9 impacts (20.1), p = 0.01] year of play. Acceleration was highest in top-of-the-head impacts [β(SE) = 4.4 g's higher (0.8), p<0.001]. CONCLUSION Including screening questions for Attention-Deficit/Hyperactivity Disorder in pre-participation evaluations can help identify a subset of prospective football players who may be at risk for increased head impacts. Position-specific strategies to modify kickoffs and correct tackling and blocking may also reduce impact burden.
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Affiliation(s)
- Kelsey L. McAlister
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Wendy J. Mack
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Cynthia Bir
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, United States of America
| | - David A. Baron
- Western University, Pomona, CA, United States of America
| | - Christine Som
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - Karen Li
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - Anthony Chavarria-Garcia
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - Siddhant Sawardekar
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - David Baron
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - Zachary Toth
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - Courtney Allem
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - Nicholas Beatty
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - Junko Nakayama
- Crescenta Valley High School, La Crescenta, CA, United States of America
| | - Ryan Kelln
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - Tracy Zaslow
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
| | - Ravi Bansal
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Bradley S. Peterson
- Institute for the Developing Mind, Children’s Hospital, Los Angeles, CA, United States of America
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
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McAlister KL, Mack W, Som C, Chavarria-Garcia A, Baron DA, Zaslow T, Bir C, Baron D, Bansal R, Peterson BS. Associations Between Personal Traits And Head Impact Frequency And Force Among High School Football Athletes. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000880512.14644.c9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zink J, Yang CH, McAlister KL, Huh J, Pentz MA, Page KA, Belcher BR, Dunton GF. Patterns of Objectively Measured Sedentary Time and Emotional Disorder Symptoms Among Youth. J Pediatr Psychol 2022; 47:757-768. [PMID: 35260899 PMCID: PMC9297093 DOI: 10.1093/jpepsy/jsac014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE We examined the within-person longitudinal and bidirectional associations between patterns of sedentary time accumulation [alpha (sedentary bout duration/length), sedentary breaks (number of breaks in sedentary bouts)], and symptoms of major depressive disorder and generalized anxiety disorder. METHODS Children [N = 167, 10.1(0.9) years old, 54.5% female, 59.3% Hispanic, 35.9% overweight/obese at baseline] participated in a 3-year longitudinal study that consisted of assessments of sedentary time, and depressive and anxiety symptoms. At each assessment, participants wore accelerometers and completed the Revised Child Anxiety and Depression Scale. Separate random intercept cross-lagged panel models estimated the within-person longitudinal and bidirectional associations between alpha, sedentary breaks, and symptoms of major depressive disorder and generalized anxiety disorder across chronological age intervals. RESULTS Having greater than one's own usual depressive symptoms at age 11 was associated with fewer sedentary breaks 1 year later. Having greater than one's own usual generalized anxiety symptoms at age 11 was associated with longer sedentary bouts and fewer sedentary breaks 1 year later. In contrast, having greater than one's own usual sedentary breaks at age 10 was associated with fewer generalized anxiety symptoms 1 year later. All other associations, including at younger ages, were null. CONCLUSION Deviations from one's usual levels of depressive or anxiety symptoms may be important for how sedentary time is subsequently accumulated. Intraindividual processes appear to be at play, therefore more within-person research is needed. Intervention strategies for promoting a healthier accumulation of sedentary time may consider targeting occasions when depressive and anxiety symptoms are greater than usual.
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Affiliation(s)
- Jennifer Zink
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Chih-Hsiang Yang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, USA
| | - Kelsey L McAlister
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Jimi Huh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Mary Ann Pentz
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Kathleen A Page
- Department of Medicine, Keck School of Medicine, University of Southern California, USA
| | - Britni R Belcher
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
- Department of Psychology, University of Southern California, USA
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Zink J, Yang CH, Alves JM, McAlister KL, Huh J, Pentz MA, Page KA, Dunton GF, Belcher BR. Time-Varying Associations Between Device-Based and Ecological Momentary Assessment-Reported Sedentary Behaviors and the Concurrent Affective States Among Adolescents: Proof-of-Concept Study. JMIR Form Res 2022; 6:e37743. [PMID: 35687383 PMCID: PMC9233247 DOI: 10.2196/37743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Previous studies on affective state-sedentary behavior (SB) associations have not accounted for their potentially time-varying nature and have used inconsistent SB measurement modalities. We investigated whether the strength of the associations between affective states and SB varied as a function of the time of day and by SB measurement modality (device-measured SB vs ecological momentary assessment-reported screen-based SB) in youth. OBJECTIVE This study aimed to establish a proof of concept that SB-affective state associations may not be static during the day. In addition, we aimed to inform the methodology of future work, which may need to model associations as functions of the time of day and carefully consider how SB is operationalized or measured. METHODS A total of 15 adolescents (age: mean 13.07, SD 1.03 years; 10/15, 67% female; 6/15, 40% Hispanic; 10/15, 67% healthy weight) wore thigh-mounted activPAL accelerometers and simultaneously reported their screen-based SBs and concurrent positive and negative affective states via ecological momentary assessment for 7 to 14 days (N=636 occasions). Time-varying effect models (varying slopes) examined how each measure of SB was associated with concurrent affective states from 7 AM to 8 PM. RESULTS Time-varying effect model plots revealed that these associations varied in strength throughout the day. Specifically, device-based SB was related to greater concurrent negative affect only after approximately 5 PM and was unrelated to concurrent positive affect. Screen-based SB was related to greater concurrent negative affect only from 7 AM to approximately 9 AM. This was also related to greater concurrent positive affect from 7 AM to approximately 9:30 AM and from approximately 3 PM to approximately 7 PM. CONCLUSIONS We provide preliminary evidence to suggest that future confirmatory studies investigating the SB-affective state relationship should consider the time-varying nature of these associations and SB measurement modality. There may be critical time windows when specific types of SBs co-occur with affect, suggesting that interventions may need tailoring to the time of day and type of SB if future studies using similar methodologies can replicate our findings.
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Affiliation(s)
- Jennifer Zink
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Chih-Hsiang Yang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Jasmin M Alves
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Kelsey L McAlister
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jimi Huh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Mary Ann Pentz
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Kathleen A Page
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Britni R Belcher
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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McAlister KL, Fisher KL, Dumont-Driscoll MC, Rubin DA. The relationship between metabolic syndrome, cytokines and physical activity in obese youth with and without Prader-Willi syndrome. J Pediatr Endocrinol Metab 2018; 31:837-845. [PMID: 29975666 DOI: 10.1515/jpem-2017-0539] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/04/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND The objective of this study was to examine the associations between adiposity, metabolic syndrome (MetS), cytokines and moderate-to-vigorous physical activity (MVPA) in youth with Prader-Willi syndrome (PWS) and non-syndromic obesity (OB). METHODS Twenty-one youth with PWS and 34 with OB aged 8-15 years participated. Measurements included body composition, blood pressure, fasting blood markers for glucose control, lipids and inflammation and MVPA. Group differences for adiposity, MetS, blood parameters and MVPA were determined using independent t-tests and chi-square (χ2) analyses. Bivariate correlations and analysis of variance (ANOVA) examined the associations between adiposity, MetS severity, cytokines and MVPA. RESULTS PWS presented similar percentage of body fat (%), lower body mass index (BMI) z-scores, insulin resistance, triglycerides, MetS severity, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and MVPA and higher high-density lipoprotein (HDL) and adiponectin (ADP) than OB. Fewer PWS presented MetS based on BMI z-score (61.9% vs. 91.2%) and glucose (14.3% vs. 44.1%) compared to OB. In all youth, MetS severity was significantly associated with body fat %, ADP, interleukin-6 (IL-6) and TNF-α and also with CRP in PWS, but associations became non-significant for CRP and IL-6 when controlling for body fat %. In PWS, those with low MVPA had significantly higher TNF-α than those with high MVPA (1.80±0.45 vs. 1.39±0.26 pg/mL). CONCLUSIONS Although PWS presented better cardiometabolic profiles than OB and lower MetS risk, associations between body fat, MetS and cytokines were somewhat similar for both groups, with the exception of CRP. Results suggest a potential role for MVPA related to MetS and inflammation and extend associations shown in OB to PWS.
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Affiliation(s)
- Kelsey L McAlister
- California State University, Fullerton, Department of Kinesiology, Fullerton, CA, USA
| | - Koren L Fisher
- California State University, Fullerton, Department of Kinesiology, Fullerton, CA, USA
| | | | - Daniela A Rubin
- California State University, Fullerton, Department of Kinesiology, Fullerton, CA, USA
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