Despite its importance for well-being, spiritual care remains under-explored in HCI, while the adoption of technology in clinical spiritual care lags behind other healthcare fields. Prior work derived a definition of "spiritual support" through co-design workshops with stakeholders in online health communities. This paper contributes: (1) a revision of that definition through member checking with professional spiritual care providers (SCPs); (2) a novel design framework—SPIRIT—which can help to expand models of delivery for spiritual care using digital technologies. Through re-analysis of previous data and new interviews with SCPs, we identify three prerequisites for meaningful spiritual care: openness to care, safe space, and the ability to discern and articulate spiritual needs. We also propose six design dimensions: loving presence, meaning-making, appropriate degree of technology use, location, degree of relational closeness, and temporality. We discuss how SPIRIT offers guidance for designing impactful digital spiritual care intervention systems within and beyond clinical settings.

Despite a growing need for spiritual care in the US, it is often under-served, inaccessible, or misunderstood, while almost no prior work in CSCW/HCI research has engaged with professional chaplains and spiritual care providers. This interdisciplinary study aims to develop a foundational understanding of how spiritual care may (or may not) be expanded into online spaces--especially focusing on anonymous, asynchronous, and text-based online communities. We conducted an exploratory mixed-methods study with chaplains (N=22) involving interviews and user testing sessions centered around Reddit support communities to understand participants' perspectives on technology and their ideations about the role of chaplaincy in prospective Online Spiritual Care Communities (OSCCs). Our Grounded Theory Method analysis highlighted benefits of OSCCs including: meeting patients where they are at; accessibility and scalability; and facilitating patient-initiated care. Chaplains highlighted how their presence in OSCCs could help with shaping peer interactions, moderation, synchronous chats for group care, and redirecting to external resources, while also raising important feasibility concerns, risks, and needs for future design and research. We used an existing taxonomy of chaplaincy techniques to show that some spiritual care strategies may be amenable to online spaces, yet we also exposed the limitations of technology to fully mediate spiritual care and the need to develop new online chaplaincy interventions. Based on these findings, we contribute the model of a ''Care Loop'' between institutionally-based formal care and platform-based community care to expand access and drive greater awareness and utilization of spiritual care. We also contribute design implications to guide future work in online spiritual care.