P3.028: Spirituality in Adolescent Health: A Systematic Review

Background: Since the early 2000s, interest has steadily grown concerning the relationship between spirituality – the way persons seek meaning, purpose, and identity – and health outcomes in adult populations. However, a significant gap remains in understanding how spirituality affects pediatric populations, particularly adolescents. Adolescence is a crucial developmental period marked by the establishment of critical health behaviors and the emergence of mental health issues. This study aims to fill this gap by systematically reviewing and synthesizing high-quality evidence on the role of spirituality in adolescent health, with a focus on mental health and health-related behaviors.

Methods: We conducted a comprehensive literature search across multiple electronic databases, including PubMed (NCBI), PsycINFO (EBSCO), and the Web of Science (Clarivate Analytics), to identify articles published from January 2000 to April 2022 concerning the impact of spirituality on health outcomes. Studies were selected if they prospectively examined the relationship between spirituality and health outcomes, utilized validated measures, and controlled for potential confounding factors. Inclusion criteria encompassed cohort studies, case-control studies, and meta-analyses with sample sizes of at least 1,000 participants, as well as randomized controlled trials with a minimum of 100 participants. Each study was evaluated for bias using the Cochrane criteria. From the initial pool of 12,213 articles, 225 met the inclusion criteria and were rated as having a low to moderate risk of bias. Of these, 34 articles specifically addressed spirituality in adolescent populations aged 21 years or younger.

Results: The majority of the eligible studies were prospective cohort studies (33 out of 34), with one randomized controlled trial. Of the 34 studies, 17 explored the role of spirituality in mental health outcomes, 18 examined its impact on health behaviors, and one addressed both areas. Most research was conducted in the United States (31 studies), with a few studies from Canada, Taiwan, and the United Kingdom. The average sample size was 6,155, ranging from 122 to 40,423 participants, involving ages 7 to 22 years. In mental health outcomes, 14 out of 17 studies showed that spirituality is significantly associated with reductions in depressive symptoms (7 studies), suicidal ideation and attempts (3 studies), and enhancements in psychological well-being (4 studies). Regarding health behaviors, all 18 studies revealed significant associations between spirituality and positive health behaviors such as reductions in substance use and initiation (13 studies), decreased sexual activity (3 studies), and improvements in physical health measures (2 studies).

Conclusion: Although the existing literature is sparse, available evidence indicates that spirituality is significantly associated with improved mental health outcomes and health behaviors in adolescents. These findings suggest that spirituality may serve as a valuable resource for enhancing adolescent health, warranting further global research to explore these relationships more comprehensively and inform future interventions.