ABSTRACT

This study aimed to map the available evidence on technosociality in the daily lives of primary care professionals to promote the health of people/families. This is a scoping review based on the Joanna Briggs Institute and Prisma-ScR. The PCC strategy (participants, concept and context) was used. The sample comprises 25 articles. The predominant language was English, the year, 2018, the strength of evidence, 5 and the quality of evidence, high and moderate. Technologies are part of the daily life of PHC professionals and include health control, curative and medication measures. They are sources of communication between professionals and professionals and users. For the use of technologies, it is essential that professionals are trained, using evidence-based practices to achieve the objectives in view of the needs of each one. The use of technologies to promote the health of people/families represents a technological innovation in Primary Health Care, with the possibility of impacting health conditions and promoting healthier life choices.

KEYWORDS
Technology; Primary Health Care; Mobile applications; Social networking; Health promotion

Introduction

Technosociality, according to Michel Maffesoli, is a way of socially communicating and interacting that postpone itself to technology, represented by the internet and its tools, which have become essential in everyday life in post-modern times¹1 Maffesoli M. A ordem das coisas: pensar a pós-modernidade. Rio de Janeiro: Forense; 2016.-²2 Maffesoli M. A república dos bons sentimentos. São Paulo: Iluminuras: Itaú Cultural; 2009.. Postmodern technology can be considered part of the re-enchantment of the world³3 Maffesoli M. Arcaísmo, cibercultura e reencantamento do mundo: as dobras do cotidiano tecnológico. Comunicação e Informação. 2018 [acesso em 2020 abr 29]; 21(02):04-18. Disponível em: https://doi.org/10.22478/ufpb.1981-0695.2019v14n1.44401
https://doi.org/10.22478/ufpb.1981-0695.... by the accelerated technosocial process of virtual approach to human interactions.

Communication in social media tends to favor listening and vocalization of the different groups involved⁴4 Brasil. Lei nº 12.965, de 23 de abril de 2014. Estabelece princípios, garantias, direitos e deveres para o uso da internet no Brasil. Diário Oficial da União. 24 Abr 2014., contributing to the process of making public what was private¹1 Maffesoli M. A ordem das coisas: pensar a pós-modernidade. Rio de Janeiro: Forense; 2016.. In the health area, the use of technology-based tools in Primary Health Care (PHC) has become increasingly frequent⁵5 Ramsey AT, Satterfield JM, Gerke DR, et al. Technology-Based Alcohol Interventions in Primary Care: Systematic Review. Journ al of Medical Internet Research. 2019 [acesso em 2020 abr 29]; 21(04):12. Disponível em: https://doi.org/10.2196/10859
https://doi.org/10.2196/10859... -⁶6 Jong CC, Ros WJG, Leeuwen MV, et al. The challenge of involving elderly patients in primary care using an electronic communication tool with their professionals: a mixed methods study. Journal of Innovation in Health Informatics. 2017 [acesso em 2020 abr 30]; 24(3):275-283. Disponível em: http://dx.doi.org/10.14236/jhi.v24i3.937
http://dx.doi.org/10.14236/jhi.v24i3.937... . Health professionals working in PHC can use digital technologies to promote actions to prevent risks and injuries and health education and promotion⁷7 Berman AH, Kolaas K, Petersén E, et al. Clinician experiences of healthy lifestyle promotion and perceptions of digital interventions as complementary tools for lifestyle behavior change in primary care. BMC Family Practice. 2018 [acesso em 2020 mar 5]; 19(139):01-11. Disponível em: https://doi.org/10.1186/s12875-018-0829-z
https://doi.org/10.1186/s12875-018-0829-... .

Regarding health promotion, social networks such as WhatsApp, Facebook and Twitter can be used to achieve unique strategies to optimize healthier life choices⁸8 Marin-Gomez FX, Cuyas FG, Reig-Bolano R, et al. Social Networking App Use Among Primary Health Care Professionals: Web-Based Cross-Sectional Survey. JMIR mHealth and uHealth. 2018 [acesso em 2020 abr 30]; 06(12):12. Disponível em: https://doi.org/10.2196/11147
https://doi.org/10.2196/11147... , which contributes to the construction of actions that make it possible to respond to social needs in health⁹9 Brasil. Portaria de Consolidação nº 2, de 28 de setembro de 2017. Consolida as normas sobre as políticas nacionais de saúde do SUS. Diário Oficial da União. 28 Nov 2017..

However, the introduction and use of digital technologies in PHC has caused changes and impacts in the daily work of health professionals that deserve to be investigated, considering that the various interactive means of communication, especially the internet, represent exceptional mechanisms³3 Maffesoli M. Arcaísmo, cibercultura e reencantamento do mundo: as dobras do cotidiano tecnológico. Comunicação e Informação. 2018 [acesso em 2020 abr 29]; 21(02):04-18. Disponível em: https://doi.org/10.22478/ufpb.1981-0695.2019v14n1.44401
https://doi.org/10.22478/ufpb.1981-0695.... . This scoping review is justified due to the fact that technosociality in the daily life of PHC professionals for the promotion of people/families’ health is still little explored⁵5 Ramsey AT, Satterfield JM, Gerke DR, et al. Technology-Based Alcohol Interventions in Primary Care: Systematic Review. Journ al of Medical Internet Research. 2019 [acesso em 2020 abr 29]; 21(04):12. Disponível em: https://doi.org/10.2196/10859
https://doi.org/10.2196/10859... ,⁶6 Jong CC, Ros WJG, Leeuwen MV, et al. The challenge of involving elderly patients in primary care using an electronic communication tool with their professionals: a mixed methods study. Journal of Innovation in Health Informatics. 2017 [acesso em 2020 abr 30]; 24(3):275-283. Disponível em: http://dx.doi.org/10.14236/jhi.v24i3.937
http://dx.doi.org/10.14236/jhi.v24i3.937... ,⁸8 Marin-Gomez FX, Cuyas FG, Reig-Bolano R, et al. Social Networking App Use Among Primary Health Care Professionals: Web-Based Cross-Sectional Survey. JMIR mHealth and uHealth. 2018 [acesso em 2020 abr 30]; 06(12):12. Disponível em: https://doi.org/10.2196/11147
https://doi.org/10.2196/11147... . Therefore, the following question arises: what is the state of the art on the use of health technologies and virtual social networks by PHC health professionals to promote the health of people/families.

This study aimed to map the available evidence on the use of health technologies and virtual social networks in the daily lives of PHC professionals and the promotion of health for people/families.

Material and methods

It is a scoping review based on the Joanna Briggs Institute and on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma-ScR)¹⁰10 Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and Explanation. Annals of Internal Medicine. 2018 [acesso em 2020 jan 5]; 169(07):467-73. Disponível em: https://doi.org/10.7326/m18-0850
https://doi.org/10.7326/m18-0850... . The research protocol was registered in the Open Science Framework (https://osf.io/hyv8b/) It shows a comprehensive and impartial synthesis of relevant studies that address the use of technosociality in the daily life of PHC professionals to promote the health of people/families in post-modernity.

This type of review is characterized by presenting a broad topic approach and very specific research questions, making it possible for researchers to carry out the quality assessment of the included studies. Thus, through scoping review, it is possible to map evidence on certain topics, enabling concepts, dimension, scope and nature of studies to be explored, condensing and publishing the synthesized results, as well as surveying gaps about the studies available in databases¹⁰10 Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and Explanation. Annals of Internal Medicine. 2018 [acesso em 2020 jan 5]; 169(07):467-73. Disponível em: https://doi.org/10.7326/m18-0850
https://doi.org/10.7326/m18-0850...

11 Daudt HML, Van Mossel C, Scott SJ. Enhancing the scoping study methodology: a large, inter-professional team’s experience with Arksey and O’Malley’s framework. BMC Medical Research Methodology. 2013 [acesso em 2020 abr 5]; 13(48):01-09. Disponível em: http://dx.doi.org/10.1186/1471-2288-13-48
http://dx.doi.org/10.1186/1471-2288-13-4... -¹²12 Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005 [acesso em 2020 fev 25]; 08(01):19-32. Disponível em: https://doi.org/10.1080/1364557032000119616
https://doi.org/10.1080/1364557032000119... .

This scoping review was developed following eight steps, starting with the formulation of the review question; definition of inclusion and exclusion criteria; location of studies through search in databases; selection of studies; evaluation of the quality of studies; data extraction; data analysis; synthesis of relevant data¹³13 Aromataris E, Munn Z, editores. JBI Manual for Evidence Synthesis. C. s.: JBI; 2020. [acesso em 2021 set 5]. Disponível em: https://wiki.jbi.global/display/MANUAL/Downloadable+PDF+-+current+version?preview=/61636614/67733014/JBIMES_2020August.pdf
https://wiki.jbi.global/display/MANUAL/D... . To classify the quality of evidence in the studies, the Grading of Recommendations Assessment, Development and Evaluation (Grade) was considered, in order to obtain transparency and simplicity, considering four levels of evidence quality: high, moderate, low and very low¹⁴14 Guyatt GH, Oxman AD, Visit GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. Journal BMJ. 2008 [acesso em 2020 abr 5]; 336(7650):924-926. Disponível em: https://doi.org/10.1136/bmj.39489.470347.AD
https://doi.org/10.1136/bmj.39489.470347... .

The research considered the time span from 2016 to 2019. The civil mark of the internet in Brazil was given by Law No. 12,965, of April 23, 2014, which establishes principles, guarantees, rights and duties for the use of the internet in Brazil⁴4 Brasil. Lei nº 12.965, de 23 de abril de 2014. Estabelece princípios, garantias, direitos e deveres para o uso da internet no Brasil. Diário Oficial da União. 24 Abr 2014., and by Decree No. 8,771, of May 11, 2016, which rules for various topics dealt with in Law No. 12,965/2014 and which depended on regulation after two years of discussion¹⁵15 Brasil. Decreto nº 8.771, de 11 de maio de 2016. Regulamenta a Lei nº 12.965, de 23 de abril de 2014 para tratar das hipóteses admitidas de discriminação de pacotes de dados na internet e de degradação de tráfego, indicar procedimentos para guarda e proteção de dados por provedores de conexão e de aplicações, apontar medidas de transparência na requisição de dados cadastrais pela administração pública e estabelecer parâmetros para fiscalização e apuração de infrações. Diário Oficial da União. 11 Maio 2016.. The search was performed in PubMed (National Institutes of Health), SciELO (Scientific Electronic Library Online), Scopus, Web of Science, Lilacs (Latin American and Caribbean Health Sciences), Cinahl (Cumulative Index to Nursing and Allied Health Literature) and Cochrane (Cochrane Library).

Inclusion criteria were full articles available and empirical and theoretical studies, in Portuguese, English and Spanish. Using the Participants, Concept and Context (PCC) strategy, this scoping review included studies that: a) refer to health professionals working in PHC; b) consider the concept and use of technologies; c) cover the context of impact on health promotion. Studies in project phases, which did not clearly present the results and whose focus did not correspond to the proposed theme, were excluded from the research.

The search was carried out from January to April 2020, using the following Boolean descriptors and operators: “Primary Health Care” AND “Technology” AND “Health Promotion”; “Primary Health Care” AND “Social Networking” AND “Health Promotion”; “Primary Health Care” AND “Mobile applications” AND “Health Promotion”; “Primary Health Care” AND “Technology” AND “Health Behavior”; “Primary Health Care” AND “Mobile applications”; “Primary Health Care” AND “Health Promotion”; “Primary Health Care” AND “Technology”; “Technology” AND “Health Behavior”.

Data selection was structured according to the following steps: in the 1st step, the Boolean descriptors and operators used in the study were defined, as well as the search databases: PubMed, Scopus, SciELO, Web of Science, Lilacs, Cinahl and Cochrane. In the 2nd stage, there was the application of filters: text available in a free and complete way; languages - English, Portuguese and Spanish; year - 2016 to 2019 on the defined bases. To find out if the articles corresponded to the research question, the titles and descriptors were read. In the 3rd stage, the abstract, introduction and conclusion of each article was read, in order to verify its relevance for the study and whether the inclusion and exclusion criteria were met. Finally, in the 4th stage, the pre-selected articles were read in full by the researchers, with the aim of verifying with greater precision their relevance to the study and whether the inclusion and exclusion criteria were met. We then proceeded to extract relevant data for further analysis, taking into account the previously established protocol.

The reading of the full articles and application of the inclusion and exclusion criteria enabled the data extraction. The articles were analyzed in terms of quality and categorized by degree of recommendation and level of evidence, according to the classification developed by the Evidence-Based Practice (EBP).

EBP and evidence-based health care embrace the same concepts and principles as evidence-based medicine and are employed by various professionals and in different health contexts. EBP has been conceptualized as the conscious, judicious and explicit use of the best and most current research evidence in making clinical decisions about individual patient care. This hierarchy guides the criteria for classifying evidence levels for different types of studies¹⁶16 Bennett S, Bennett JW. The process of evidence-based practice in occupational therapy: informing clinical decisions. Australian Occupational Therapy Journal. 2000 [acesso em 2020 mar 10]; 47(01):171-80. Disponível em: https://doi.org/10.1046/j.1440-1630.2000.00237.x
https://doi.org/10.1046/j.1440-1630.2000...

17 Sampaio RF, Mancini MC. Systematic review studies: A guide for careful synthesis of the scientific evidence. Revista Brasileira de Fisioterapia. 2007 [acesso em 2020 mar 10]; 11(01):83-89. Disponível em: https://doi.org/10.1590/S1413-35552007000100013
https://doi.org/10.1590/S1413-3555200700... -¹⁸18 Sackett DL, Straus SE, Richardson WS, et al. Evidence-based medicine: How to practice and teach EBM. 2. ed. Edinburgh: Churchill Livingstone; 1996..

Evidence can be characterized as something that provides proof for decision making, encompassing study results and consensus of recognized experts¹⁹19 Stetler CB, Brunell M, Giuliano KK, et al. Evidence-based practice and the role of nursing leadership. Journal of Nursing Administration. 1998 [acesso em 2020 mar 15]; 28(07-08):45-53. Disponível em: https://doi.org/10.1097/00005110-199807000-00011
https://doi.org/10.1097/00005110-1998070... .

The strength of evidence can be classified into five distinct levels: level 1, when it is strong evidence from, at least, a systematic review of multiple controlled, randomized, well-designed studies; level 2, when there is strong evidence from at least one randomized, controlled study, of appropriate design and adequate size; level 3, when it is referring to evidence from well-designed studies without randomization, single group pre and post-cohort, time series or paired case-control; level 4, when related to evidence from studies, of non-experimental orders, carried out in research centers or groups; and level 5, when it covers opinions of respected authorities, based on clinical evidence, reports from expert committees or descriptive studies²⁰20 Gray MJA. Evidence based healthcare: how to make health policy and management decision. Edinburgh: Churchill Livingstone; 1997..

The process of identification, selection, eligibility and inclusion of studies in this scoping review can be seen in figure 1.

Results

The search in the databases was refined through filters: free and complete text available; languages in English, Portuguese and Spanish; publication date between 2016 and 2019. A total of 5,029 studies were obtained, of which 283 were excluded because they were duplicates, resulting in 4,746 documents. After reading the abstract, introduction and conclusion of each article to identify its relevance for the research and if it met the inclusion or exclusion criteria, arriving at a total of 125 articles, from the PubMed (28), SciELO (18), Scopus (21), Web of Science (11), Cinahl (36) and Cochrane (11). Subsequently, the articles were read in full and, at this stage, studies with no consistency with the theme, different sample populations of PHC professionals, studies in the design phase or without clear results were excluded, obtaining, for this scoping review, a final sample of 25 articles.

The years of publication spanned from 2016 to 2019, with 2018 being the most representative year, with 11 articles. The predominant language was English (22), followed by Portuguese (02) and Spanish (01). These studies were carried out in Brazil (05), Spain (03), Sweden (03), Ireland (02), USA (02), Africa (01), China (01), Norway (01), United Kingdom (01), Australia (01), Poland (01), Netherlands (01) and Canada (01). Two studies did not report the location where they were carried out.

Considering the strength of evidence among the levels, the one with the highest prevalence was level 5 (10), subsequent to level 2 (05), level 3 (04), level 1 (04) and level 4 (02).

As for the quality of evidence from the Grade system, among its levels, the ones that presented the highest prevalence were high quality (09) and moderate quality (09), subsequent to low quality (05) and very low quality (02).

Considering the participants - health professionals working in PHC, the concept - the use of technologies, context - the impact on health promotion, the results obtained can be seen in table 1.

Discussion

The literature mapping in this scoping review presents a synthesis of studies that address the concept of the use of technologies by PHC professionals in the context of health promotion.

The introduction of technologies in the health system caused the emergence of new concepts, prompting reflection on the potential and limitations of the applicability of these technologies in the daily lives of health professionals and users²¹21 Oliver-Mora M, Iñiguez-Rueda L. El uso de las tecnologías de la información y la comunicación (TIC) en los centros de salud: la visión de los profesionales en Cataluña, España. Revista Interface. 2017 [acesso em 2020 mar 5]; 21(63):945-955. Disponível em: https://doi.org/10.1590/1807-57622016.0331
https://doi.org/10.1590/1807-57622016.03... ,²²22 Plessis LM, Koornhof HE, Marais ML, et al. Implementation of the Road-to-Health-Booklet health promotion messages at primary health care facilities, Western Cape Province, South Africa Western Cape Province, South Africa. South African journal of child health. 2017 [acesso em 2020 fev 10]; 11(04):164-169. Disponível em: http://www.scielo.org.za/pdf/sajch/v11n4/09.pdf
http://www.scielo.org.za/pdf/sajch/v11n4... . Transversal knowledge in postmodern sociality, induced by the development of interactive media, is considered an original wisdom in which there is collective production of knowledge and common access to it²³23 Maffesoli M. O tempo retorna: formas elementares da pós-modernidade. Rio de Janeiro: Forense Universitária; 2012..

Information technologies, such as social networks, represent an increasingly important element of social life²2 Maffesoli M. A república dos bons sentimentos. São Paulo: Iluminuras: Itaú Cultural; 2009.,²³23 Maffesoli M. O tempo retorna: formas elementares da pós-modernidade. Rio de Janeiro: Forense Universitária; 2012.,²⁴24 Maffesoli M. Pactos emocionais: reflexões em torno da moral, da ética e da deontologia. Curitiba: PUCPRESS; 2018., since “a technological culture tends to contaminate the whole of daily life”¹1 Maffesoli M. A ordem das coisas: pensar a pós-modernidade. Rio de Janeiro: Forense; 2016.(77). Social networks are increasingly being used by PHC health professionals, representing important tools that can be used in favor of health and for health promotion actions.

Social networks, such as Facebook, WhatsApp, Twitter, Instagram and others, are used for communication actions between professionals, clinical or drug consultations, professional development and health promotion⁸8 Marin-Gomez FX, Cuyas FG, Reig-Bolano R, et al. Social Networking App Use Among Primary Health Care Professionals: Web-Based Cross-Sectional Survey. JMIR mHealth and uHealth. 2018 [acesso em 2020 abr 30]; 06(12):12. Disponível em: https://doi.org/10.2196/11147
https://doi.org/10.2196/11147... . In this scoping review, it was observed that health promotion appeared among the main motivations for the use of applications by professionals, representing 72% of the selected studies. Others addressed actions to monitor patients²⁵25 Mastellos N, Bliźniuk G, Czopnik D, et al. Feasibility and acceptability of TRANSFoRm to improve clinical trial recruitment in primary care. Family Practice. 2016 [acesso em 2020 fev 20]; 33(02):186-191. Disponível em: https://doi.org/10.1093/fampra/cmv102
https://doi.org/10.1093/fampra/cmv102... , in addition to being a source of communication between professionals²⁶26 Lofters AK, Slater MB, Angl EN, et al. Facebook as a tool for communication, collaboration, and informal knowledge exchange among members of a multisite family health team. Journal of Multidisciplinary Healthcare. 2016 [acesso em 2020 mar 20]; 25(9):29-34. Disponível em: https://doi.org/10.2147/JMDH.S94676
https://doi.org/10.2147/JMDH.S94676... ,²⁷27 Keyworth C, Hart J, Armitage CJ, et al. What maximizes the effectiveness and implementation of technology-based interventions to support healthcare professional practice? A systematic literature review. BMC Medical Informatics and Decision Making. 2018 [acesso em 2020 mar 15]; 18(93):21. Disponível em: https://doi.org/10.1186/s12911-018-0661-3
https://doi.org/10.1186/s12911-018-0661-... or professionals/users²⁸28 Smailhodzic E, Hooijsma W, Boonstra A, et al. Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals. BMC Health Services Research. 2016 [acesso em 2020 abr 15]; 16(442):14. Disponível em: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1691-0
https://bmchealthservres.biomedcentral.c... , collection of data²⁵25 Mastellos N, Bliźniuk G, Czopnik D, et al. Feasibility and acceptability of TRANSFoRm to improve clinical trial recruitment in primary care. Family Practice. 2016 [acesso em 2020 fev 20]; 33(02):186-191. Disponível em: https://doi.org/10.1093/fampra/cmv102
https://doi.org/10.1093/fampra/cmv102... ,²⁹29 Cavalcante RB, Silva HRM, Silva TIM, et al. Diffusion of the technological innovation e-sus ab: acceptance or rejection? Cogitare Enfermagem. 2018 [acesso em 2020 abr 15]; 23(3):01-13. Disponível em: https://dx.doi.org/10.5380/ce.v23i3.55911
https://dx.doi.org/10.5380/ce.v23i3.5591... ,³⁰30 Daltro EFMA, Barbosa DSJ, Machado APR, et al. Aceitação e uso de tecnologias móveis de informação pelos agentes comunitários de saúde de Sapeaçu. Revista Baiana de Saúde Pública. 2017 [acesso em 2020 abr 2]; 41(02):324-333. Disponível em: https://doi.org/10.22278/2318-2660.2017.v41.n2.a1333
https://doi.org/10.22278/2318-2660.2017.... and records²⁹29 Cavalcante RB, Silva HRM, Silva TIM, et al. Diffusion of the technological innovation e-sus ab: acceptance or rejection? Cogitare Enfermagem. 2018 [acesso em 2020 abr 15]; 23(3):01-13. Disponível em: https://dx.doi.org/10.5380/ce.v23i3.55911
https://dx.doi.org/10.5380/ce.v23i3.5591... .

WhatsApp is the application most used by health professionals, followed by Facebook, as a means of communicating and sharing clinical information, which can pose a risk to the security of patient data⁸8 Marin-Gomez FX, Cuyas FG, Reig-Bolano R, et al. Social Networking App Use Among Primary Health Care Professionals: Web-Based Cross-Sectional Survey. JMIR mHealth and uHealth. 2018 [acesso em 2020 abr 30]; 06(12):12. Disponível em: https://doi.org/10.2196/11147
https://doi.org/10.2196/11147... . Facebook proved to be a powerful tool for communication and health promotion involving the community in general³¹31 Bernardes VP, Dias LF, Pereira MA, et al. Facebook como Ferramenta Pedagógica em Saúde Coletiva: Integrando Formação Médica e Educação em Saúde. Revista Brasileira de Educação Médica. 2019 [acesso em 2020 abr 3]; 43(01):652-661. Disponível em: http://dx.doi.org/10.1590/1981-5271v43suplemento1-20190192
http://dx.doi.org/10.1590/1981-5271v43su... .

Community sites of the internet testify to ethics. It is private and, at times, can be immoral, breaking laws, as well as what is socially admitted²⁴24 Maffesoli M. Pactos emocionais: reflexões em torno da moral, da ética e da deontologia. Curitiba: PUCPRESS; 2018..

The SmartMove mobile app is intended to promote physical activities. It is an easy-to-use application, which may have contributed positively to user adherence. Smartphone technology, widget, and stage count screen graphics are able to monitor the progress of users in overweight and obese conditions while exercising. The space provided by technology can help healthcare professionals deal with obesity and lifestyle sensitivities. It is necessary for a specific member of the service provider’s team to drive the use of the application by other team members³²32 Glynn LG, Glynn F, Casey M, et al. Implementation of the SMART MOVE intervention in primary care: a qualitative study using normalisation process theory. BMC Family Practice, United Kingdom. 2018 [acesso em 2020 abr 15]; 19(48):10. Disponível em: https://doi.org/10.1186/s12875-018-0737-2
https://doi.org/10.1186/s12875-018-0737-... .

The DiaCert app can help professionals in the clinical follow-up of patients with type 2 diabetes mellitus, encourage patients to have healthier lifestyle habits and physical practices, allow patients to share their personal data with their professional, receive information related to hemoglobin glycated, directly from the health system to the smartphone³³33 Bonn SE, Alexandrou C, Steiner KH, et al. App-technology to increase physical activity among patients with diabetes type 2 - the DiaCert-study, a randomized controlled trial. BMC Public Health. 2018 [acesso em 2020 mar 5]; 18(119):01-07. Disponível em: https://doi.org/10.1186/s12889-018-5026-4
https://doi.org/10.1186/s12889-018-5026-... .

The use of cell phone applications or blood pressure monitors by patients may have the potential to increase the amount of blood pressure data available to healthcare professionals, provided that the quality of this data is ensured for clinical decision-making in the treatment of systemic arterial hypertension. This approach can also facilitate greater awareness and self-care on the part of patients, taking into account that technology allows the patient to be able to visualize, with greater clarity, the effect and importance of changing lifestyles and the antihypertensives drugs³⁴34 Morrissey EC, Glynn LG, Casey M, et al. New self-management technologies for the treatment of hypertension: general practitioners’ perspectives. Family Practice. 2018 [acesso em 2020 abr 5]; 35(03):318-322. Disponível em: https://doi.org/10.1093/fampra/cmx100
https://doi.org/10.1093/fampra/cmx100... .

The social mutation caused by post-modernity brings into force the need for a transmutation of language²³23 Maffesoli M. O tempo retorna: formas elementares da pós-modernidade. Rio de Janeiro: Forense Universitária; 2012.. Carrying out health interventions, using a combination of nutritional counseling and a diet application, proved to be more efficient than when the health professional performs only isolated counseling. The complementary use of this tool proved to be able to improve users’ adherence to both healthier eating and physical activity practices³⁵35 Recio-Rodriguez JI, Conde CA, Calvo-Aponte MJ, et al. The Effectiveness of a Smartphone Application on Modifying the Intakes of Macro and Micronutrients in Primary Care: A Randomized Controlled Trial. The EVIDENT II Study. Nutrients, Switzerland. 2018 [acesso em 2020 abr 5]; 10(10):16. Disponível em: https://doi.org/10.3390/nu10101473
https://doi.org/10.3390/nu10101473... .

The use of technological bases such as the web, cell phones or computers, by health professionals, to promote change in behavior related to alcohol had a positive effect, considering that it can reduce its consumption and/or subsequent damage. The use of these technologies showed that the degree to which patients and professionals considered digital interventions acceptable, viable and sustainable can influence the effectiveness of interventions⁵5 Ramsey AT, Satterfield JM, Gerke DR, et al. Technology-Based Alcohol Interventions in Primary Care: Systematic Review. Journ al of Medical Internet Research. 2019 [acesso em 2020 abr 29]; 21(04):12. Disponível em: https://doi.org/10.2196/10859
https://doi.org/10.2196/10859... .

WeChat, used to receive short-term training on dementia, such as lectures, video sharing and group discussions, has influenced changes in professionals’ behavior. The acquisition of knowledge about risk factors to which people are susceptible can increase early detection, referral to specialized centers, the quality of care and treatment offered to patients and caregivers, as well as encourage professionals to promote educational actions in health³⁶36 Wang F, Xião LD, Wang K, et al. Evaluation of a WeChat-based dementia-specific training program for nurses in primary care settings: A randomized controlled trial. Applied Nursing Research, Philadelphia. 2017 [acesso em 2020 abr 10]; 38(01):51-59. Disponível em: https://doi.org/10.1016/j.apnr.2017.09.008
https://doi.org/10.1016/j.apnr.2017.09.0... .

The use of blogs was a qualitative leap in communication between health professionals working in PHC, as it allowed for debate and participation between them. The introduction of this technology can also improve the dialogue/interaction between professionals and patients, thus promoting person-centered care²¹21 Oliver-Mora M, Iñiguez-Rueda L. El uso de las tecnologías de la información y la comunicación (TIC) en los centros de salud: la visión de los profesionales en Cataluña, España. Revista Interface. 2017 [acesso em 2020 mar 5]; 21(63):945-955. Disponível em: https://doi.org/10.1590/1807-57622016.0331
https://doi.org/10.1590/1807-57622016.03... . It is noted that, through the use of communication sites such as blogs, it is possible to share common emotions²³23 Maffesoli M. O tempo retorna: formas elementares da pós-modernidade. Rio de Janeiro: Forense Universitária; 2012., in addition to making it possible to carry out the dissemination of health information, covering other areas, such as case monitoring and health promotion³⁷37 Pinto LF, Rocha CMF. Innovations in Primary Health care: the use of communications technology and information tools to support local management. Ciênc. Saúde Colet. 2016 [acesso em 2020 mar 2]; 21(05):1433-1448. Disponível em: https://doi.org/10.1590/1413-81232015215.26662015
https://doi.org/10.1590/1413-81232015215... . By empowering patients through education, they can participate in decision-making regarding their health status and promoting it²¹21 Oliver-Mora M, Iñiguez-Rueda L. El uso de las tecnologías de la información y la comunicación (TIC) en los centros de salud: la visión de los profesionales en Cataluña, España. Revista Interface. 2017 [acesso em 2020 mar 5]; 21(63):945-955. Disponível em: https://doi.org/10.1590/1807-57622016.0331
https://doi.org/10.1590/1807-57622016.03... .

Information technologies allow professional/user interaction outside of formal consultation, improve communication and information sharing between professionals in order to achieve better health outcomes, access to information to support education and interventions, as well as tracking digital. The use of the Nutritics app, by nutritionists, for tracking food intake, administrative technology, patient management and data analysis systems, electronic health records and consultations, proved to be effective in promoting diet control and healthy eating. Tracking food intake can help empower patients and achieve better results³⁸38 Jones A, Mitchell LJ, O’Connor R, et al. Investigating the Perceptions of Primary Care Dietitians on the Potential for Information Technology in the Workplace: Qualitative Study. Journal of Medical Internet Research. 2018 [acesso em 2020 abr 10]; 20(10):27. Disponível em: https://doi.org/10.2196/jmir.9568
https://doi.org/10.2196/jmir.9568... .

The development and use of the DropSync mobile application allows the collection and management of data, optimizing the process of recording and storing, sending and analyzing selected information³⁹39 Pereira IM, Bonfim D, Peres HHC, et al. Mobile application for data collection in health research. Acta Paulista de Enfermagem. 2017 [acesso em 2020 abr 2]; 30(5):479-488. Disponível em: https://doi.org/10.1590/1982-0194201700069
https://doi.org/10.1590/1982-01942017000... .

The use of mobile technology (tablets) by Community Health Agents (ACS) in Brazil is aimed at recording data, filling out forms used in the daily life of the ACS, not evidencing health promotion actions. The low previous experience with Information and Communication Technology (ICT) does not represent an impediment to the use of the tablet. Weaknesses include the difficulty of simultaneous manual and computerized records and the relative delay in transmitting the collected data. Such weaknesses may result in the minimization of part of the expected benefits from the use of the tablet³⁰30 Daltro EFMA, Barbosa DSJ, Machado APR, et al. Aceitação e uso de tecnologias móveis de informação pelos agentes comunitários de saúde de Sapeaçu. Revista Baiana de Saúde Pública. 2017 [acesso em 2020 abr 2]; 41(02):324-333. Disponível em: https://doi.org/10.22278/2318-2660.2017.v41.n2.a1333
https://doi.org/10.22278/2318-2660.2017.... .

Telemedicine for wound treatment optimizes communication between health professionals in PHC and outpatient clinics, enabling the use of images and their description, discussion and reflection on the treatment and improvement in the quality of records⁴⁰40 Kolltveit BCH, Gjengedal E, Graue M, et al. Telemedicine in diabetes foot care delivery: health care professionals’ experience. BMC Health Services Research. 2016 [acesso em 2020 mar 10]; 16(134):08. Disponível em: https://doi.org/10.1186/s12913-016-1377-7
https://doi.org/10.1186/s12913-016-1377-... .

Breast cancer prevention apps can be used for early detection and early treatment⁴¹41 Houghton LC, Howland RE, Mcdonald JA. Mobilizing Breast Cancer Prevention Research Through Smartphone Apps: A Systematic Review of the Literature. Mobilizing Breast Cancer Prevention Research. 2019 [acesso em 2020 mar 2]; 07(01):15. Disponível em: https://doi.org/10.3389/fpubh.2019.00298
https://doi.org/10.3389/fpubh.2019.00298... . Support services for the self-management of people with chronic conditions, through the use of e-Health telemedicine, have been adopted in the daily lives of professionals⁴²42 Oberg U, Orre CJ, Isaksson U, et al. Swedish primary healthcare nurses’ perceptions of using digital eHealth services in support of patient self‐management. Scandinavian Journal of Caring Sciences, 2018 [acesso em 2020 abr 30]; 32(2):961-970. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/scs.12534
https://onlinelibrary.wiley.com/doi/10.1... . In addition, they support and monitor changes in health behavior for better control of chronic disease and patients proactivity in self-care/self-management activities⁴¹41 Houghton LC, Howland RE, Mcdonald JA. Mobilizing Breast Cancer Prevention Research Through Smartphone Apps: A Systematic Review of the Literature. Mobilizing Breast Cancer Prevention Research. 2019 [acesso em 2020 mar 2]; 07(01):15. Disponível em: https://doi.org/10.3389/fpubh.2019.00298
https://doi.org/10.3389/fpubh.2019.00298... .

The online consultation support technology, called e-consultation, has shown effectiveness. It allows adjustment notes, such as renewal of medication prescriptions and evaluation of test results, despite the possible work overload due to the use of the telephone for electronic consultations⁴³43 Banks J, Farr M, Salisbury C, et al. Use of an electronic consultation system in primary care: a qualitative interview study. British Journal of General Practice, Londres. 2018 [acesso em 2020 abr 29]; 68(666):01-08. Disponível em: https://doi.org/10.3399/bjgp17X693509
https://doi.org/10.3399/bjgp17X693509... . Nursing professionals show the difficulty of adapting to the use of e-Saúde technology, as they do not feel safe, in addition to the fear of not being able to interact with patients in a satisfactory manner⁴²42 Oberg U, Orre CJ, Isaksson U, et al. Swedish primary healthcare nurses’ perceptions of using digital eHealth services in support of patient self‐management. Scandinavian Journal of Caring Sciences, 2018 [acesso em 2020 abr 30]; 32(2):961-970. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/scs.12534
https://onlinelibrary.wiley.com/doi/10.1... .

It is likely that the reluctance of health professionals to use new technologies is related to the nature and reliability of the data provided, in addition to the concern with the increased workload and responsibility over the data³⁴34 Morrissey EC, Glynn LG, Casey M, et al. New self-management technologies for the treatment of hypertension: general practitioners’ perspectives. Family Practice. 2018 [acesso em 2020 abr 5]; 35(03):318-322. Disponível em: https://doi.org/10.1093/fampra/cmx100
https://doi.org/10.1093/fampra/cmx100... . “Here is the existing difficulty in apprehending the nascent post-modernity. In reducing the dense and complex real to a measurable reality”²³23 Maffesoli M. O tempo retorna: formas elementares da pós-modernidade. Rio de Janeiro: Forense Universitária; 2012.(4). This can be overcome with evidence that demonstrates efficacy and cost-effectiveness results. Health regulatory bodies can play an important role in quality control and in providing explicit guidelines regarding the implementation of new technologies in health³⁴34 Morrissey EC, Glynn LG, Casey M, et al. New self-management technologies for the treatment of hypertension: general practitioners’ perspectives. Family Practice. 2018 [acesso em 2020 abr 5]; 35(03):318-322. Disponível em: https://doi.org/10.1093/fampra/cmx100
https://doi.org/10.1093/fampra/cmx100... .

Promoting a healthy lifestyle is still a challenge, but it can be of positive coping. For professionals to be able to effectively achieve health promotion using tools and technologies, it is necessary that they are professionally trained and use evidence-based practices to achieve the goals in view of the needs of each one⁷7 Berman AH, Kolaas K, Petersén E, et al. Clinician experiences of healthy lifestyle promotion and perceptions of digital interventions as complementary tools for lifestyle behavior change in primary care. BMC Family Practice. 2018 [acesso em 2020 mar 5]; 19(139):01-11. Disponível em: https://doi.org/10.1186/s12875-018-0829-z
https://doi.org/10.1186/s12875-018-0829-... . Thus, the renewed social forms need to respond to the rethought intellectual forms¹1 Maffesoli M. A ordem das coisas: pensar a pós-modernidade. Rio de Janeiro: Forense; 2016.. It is important to maintain a balanced view of digital interventions, so that these technologies are used as a complement, that is, they do not replace face-to-face meetings between health professionals and patients⁷7 Berman AH, Kolaas K, Petersén E, et al. Clinician experiences of healthy lifestyle promotion and perceptions of digital interventions as complementary tools for lifestyle behavior change in primary care. BMC Family Practice. 2018 [acesso em 2020 mar 5]; 19(139):01-11. Disponível em: https://doi.org/10.1186/s12875-018-0829-z
https://doi.org/10.1186/s12875-018-0829-... .

It is noted that health promotion is a transversal articulation strategy, which aims to break with the excessive fragmentation in the approach of the health-illness process and reduce vulnerability, risks and damages that occur in it⁹9 Brasil. Portaria de Consolidação nº 2, de 28 de setembro de 2017. Consolida as normas sobre as políticas nacionais de saúde do SUS. Diário Oficial da União. 28 Nov 2017.. Technologies can be used by health professionals to achieve these ends⁴¹41 Houghton LC, Howland RE, Mcdonald JA. Mobilizing Breast Cancer Prevention Research Through Smartphone Apps: A Systematic Review of the Literature. Mobilizing Breast Cancer Prevention Research. 2019 [acesso em 2020 mar 2]; 07(01):15. Disponível em: https://doi.org/10.3389/fpubh.2019.00298
https://doi.org/10.3389/fpubh.2019.00298... , as technologies represent the beating heart of postmodern society¹1 Maffesoli M. A ordem das coisas: pensar a pós-modernidade. Rio de Janeiro: Forense; 2016..

All studies that are part of this review have their limitations. This scoping review had as a limitation the sample reduced by the temporal definition of collection, between 2016-2019, justified by the civil framework of the internet in Brazil and its regulation only in 2016. It presents as a contribution the synthesis of knowledge produced by a sample composed of studies from different geographic regions of the world, which address the use and the need to implement technologies in PHC to promote the health of people/families.

Conclusions

The mapping of available evidence regarding the concept ‘use of technologies’ by PHC professionals in the context of health promotion brought results that impact health conditions and promote healthier life choices.

Technologies are part of the daily lives of professionals, demonstrating effectiveness in actions to promote health and a healthier lifestyle, such as diet, physical activity and change of behaviors related to alcohol. Its use also includes health control measures, curatives and medications. In addition, it is a source of communication between professionals, professionals and users of PHC, contributing to professional development, characterized as innovative tools.

New strategies for implementing technologies in PHC are possible, with professional training and motivation, in order to ensure greater effectiveness and quality in care and health promotion for people/families.

References

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History