SCOPING REVIEW
Social support for adolescents in primary health care: a scoping review protocol
Stephanie Vanessa Penafort Martins Cavalcante1, Demilto Yamaguchi da Pureza1, Tatiana do Socorro dos Santos Calandrini1, Valdecyr Herdy Alves1, Marlucilena Pinheiro da Silva1, Diego Pereira Rodrigues2
1Universidade Federal do Amapá, Macapá, AP, Brazil
2Universidade Federal do Pará, Belém, PA, Brazil
ABSTRACT
Objective: To map the social and community support network of adolescents in primary health care. Method: The present scoping review protocol followed the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The review question is: “How is the social and community support network of adolescents established in primary health care?” Preliminary searches were conducted on Virtual Health Library, Web of Science, and Scopus. After the search on the other databases, the studies will be grouped in the Rayyan software, and duplicates will be removed. The selected studies will be evaluated by two independent review authors according to the inclusion criteria. We expect to increase knowledge about the social and community support network of adolescents and to support coping strategies for this population in primary health care, considering the social determinants to which they may be exposed.
Descriptors: Adolescents; Social Support; Primary Health Care.
INTRODUCTION
Social and community support networks (SCSNs) constitute the social capital of individuals, understood as a set of relationships and ties established between family members and the social system, which, when weakened, can have detrimental effects on an individual's health status. These networks are understood in different domains, such as emotional, representing the intensity with which the individual is supported or stimulated; tangible, referring to financial and logistical aspects; informational, consisting of access to information; and finally, coparticipative, involving an active attitude of encouragement and support(1-2).
These variables are part of the social determinants of health (SDH), defined as social, economic, cultural, ethnic/racial, psychological, and behavioral aspects that influence health and potential harm in society. Dahlgren and Whitehead’s model of SDH, organized in interrelated levels, is one of the most widely used in Brazil. In this model, distal determinants aim at macro-policies to reduce social and economic inequalities; intermediate determinants include intersectoral projects created to improve the living and working conditions of individuals; social and community networks aim to consolidate the involvement of individuals and society in activities that optimize their health status and quality of life; proximal determinants refer to the ability to control and modify behavior and lifestyle; finally, individual determinants, such as gender, age, and heredity, which cannot be directly influenced by health policies, but are relevant aspects for their creation(3-4).
Since the SDHs help to analyze how inequalities affect the prospects of access to social goods, it is necessary to understand the context of the SCSNs in which adolescents find themselves since the relationships and bonds formed by this population are dynamic and multifaceted. Their health status can be the result of numerous experiences. Adolescence is defined by the World Health Organization (WHO) as the period between the ages of 10 and 19(5).
Adolescence is a period characterized by biophysical, social, and psychological changes that significantly impact the formation of identity. As a heterogeneous group, adolescents have different needs depending on their gender, developmental stage, life experiences, and sociodemographic characteristics(6-7). Worldwide, there is a high mortality rate in adolescents related to aggression, suicide, accidents, mental health problems, sexual and reproductive health, and infectious diseases, which highlights the lack of preventive action by responsible institutions(8).
These specificities related to adolescents trigger reformulations in actions that consolidate public policies in primary health care, as this is a gateway to strengthening SCSNs. Thus, understanding this scenario allows adolescents to engage and recognize themselves as citizens, acting as protagonists of their care and participating effectively in health care programs(9).
A preliminary search of MEDLINE (Medical Literature Analysis and Retrieval System Online), Cochrane Database of Systematic Reviews, JBI Evidence Synthesis, and Open Science Framework (OSF) revealed a lack of studies on the topic. Therefore, the present study aimed to map the social and community support network of adolescents in primary health care (PHC).
METHOD
The scoping review protocol was developed on the strength of the Joanna Briggs Institute (JBI) recommendations and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. We followed the stages of framing the guiding question, identifying relevant studies, distinguishing studies, extracting information, and synthesizing results(10). The protocol has been deposited on Open Science Framework (OSF) under the DOI 10.17605/OSF.IO/D4JBU.
Review question
The acronym PCC (participants, concept, and context) was used to formulate the review question and establish eligibility criteria for selecting studies to be included in this review, where: participants, adolescents; concept: SCSNs; context: PHC. Thus, the review question was formulated as: “How is the SCSN of adolescents established in PHC?”
Inclusion criteria
Participants
Studies involving adolescents between the ages of 10 and 19 years will be included. Studies involving adolescents and young adults will be excluded.
Concept
The techniques, precautions, and interventions that encompass the SCSNs of adolescents will be analyzed as a concept. Studies related to specific diseases will be excluded.
Context
Our scoping review will consider studies from different cultural backgrounds, geographical locations, and racial or gender interests in PHC. Studies of secondary and tertiary care will be excluded.
Sources
The present study will analyze experimental and observational research as well as systematic reviews and text and opinion articles that meet the aim and question of this review protocol. There will be no restrictions regarding the year of publication and language.
Search strategy
Figures 1, 2, and 3 show the search strategies used. Keywords from the Health Sciences Descriptors and Medical Subject Headings as well as free terms in Portuguese, English, and Spanish combined with Boolean operators AND, OR, and NOT. A preliminary search of the Virtual Health Library (BVS), Web of Science (WOS), and Scopus (Scopus Preview) databases was conducted on February 13, 2023, to determine the presence and likely quantity of materials that met the inclusion criteria of the study. At that time, 1,470 studies were found.
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Database |
Search strategy |
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BVS
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((mh:(Adolescente)) OR (Adolescência) OR (Jovem*) OR (Juventude)) AND ((mh:(Determinantes Sociais da Saúde)) OR (Determinante de Saúde) OR (Determinantes Estruturais da Saúde) OR (Determinantes Sociais de Saúde) OR (Apoio Social) OR (Parceiro Social) OR (Suporte Social ) OR (Redes Comunitárias) OR (Arquitetura) OR (Laços Sociais) OR (Arquitetura de Relações Sociais) OR (Arquitetura de Vínculos Sociais ) OR (Rede de Assistência Comunitária ) OR (Rede de Cuidado Comunitário) OR (Rede de Saúde Comunitária) OR (Rede de Saúde da Comunidade)) AND ((mh:(Atenção Primária à Saúde)) OR (Atendimento Básico) OR (Atenção Básica) OR (Cuidado de Saúde Primário) OR (Cuidados Primários )OR (Cuidados de Saúde Primários)) AND NOT ((mh:(Adulto)) OR (Adulto Jovem) OR (mh:(Pré-Escolar)) OR (mh:(Recém-Nascido)) OR (mh:(Lactente)) OR (Pessoa de Meia-Idade)) |
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((mh:(Adolescente)) OR (Adolescencia) OR (Joven) OR (Jóvenes) OR (Juventud)) AND ((mh:(Determinantes Sociales de la Salud)) OR (Determinante de salud) OR (Determinantes estructurales de la salud) OR (Apoyo Social) OR (Aliados Sociales) OR (Soporte Social) OR (Redes comunitarias) OR (Arquitectura de lazos sociales) OR (Arquitectura de relaciones sociales) OR (Arquitectura de vínculos sociales) OR (Red comunitaria de salud) OR (Red de salud de la comunidad) OR (Redes comunitarias de salud) OR (Redes de atención comunitaria) OR (Redes de salud comunitaria)) AND ((mh:(Atención Primaria de Salud)) OR (Asistencia Primaria) OR (Atención Básica) OR (Atención Primaria) OR (Primer Nivel de Atención)) AND NOT ((mh:(Adulto Joven)) OR (mh:(Adulto)) OR (mh:(Niño)) OR (mh:(Preescolar)) OR (mh:(Recién Nacido)) OR (mh:(Lactante)) OR (mh:(Persona de Mediana Edad))) |
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((mh:(Adolescent)) OR (Adolescence) OR (Youth*) OR (Juvenile*)) AND ((mh:(Social Determinants of Health)) OR (Social Determinant ) OR (Social Determinants) OR (Social Support*) OR (Partner Support) OR (Community Network*) OR (Social Architecture) OR (Social Bonds) OR (Community Care Network) OR (Community Health Network) OR (Community Health Services) OR (Community Health Centers)) AND ((mh:(Primary Health Care)) OR (Primary Care) OR (Primary Healthcare) OR (Basic Health Care) OR (Basic Healthcare) OR (Primary Medical Care)) AND NOT ((mh:(Adult)) OR (Child*) OR (Preschool*) OR (Infant*) OR (Newborn*) OR (Middle Aged) OR (Children) OR (Young*) OR (Disease*)) |
Figure 1 – Preliminary search strategy used on Virtual Health Library. Macapá, AP, Brazil, 2024
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Database |
Search strategy |
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WoS |
((Adolescente* OR Adolescência OR Jovem* OR Juventude) (All Fields) AND (Determinantes Sociais da Saúde OR Determinante de Saúde OR Determinantes Estruturais da Saúde OR Determinantes Sociais de Saúde OR Apoio Social OR Parceiro Social OR Suporte Social OR Redes Comunitárias OR Arquitetura de Laços Sociais OR Arquitetura de Relações Sociais OR Arquitetura de Vínculos Sociais OR Rede de Assistência Comunitária OR Rede de Cuidado Comunitário OR Rede de Saúde Comunitária OR Rede de Saúde da Comunidade) (All Fields) AND (Atenção Primária à Saúde OR Atendimento Básico OR Atenção Básica OR Atendimento Primário de Saúde OR Cuidado de Saúde Primário OR Cuidados Primários OR Cuidados de Saúde Primários) (All Fields) NOT (Adulto OR Adulto Jovem OR Pré-Escolar OR Recém-Nascido OR Lactente OR Pessoa de Meia-Idade) (All Fields)) |
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((Adolescente) OR (Adolescencia) OR (Joven) OR (Jóvenes) OR (Juventud)) (All Fields) AND ((Determinantes Sociales de la Salud) OR (Determinante de salud) OR (Determinantes estructurales de la salud) OR (Apoyo Social) OR (Aliados Sociales) OR (Soporte Social) OR (Redes comunitarias) OR (Arquitectura de lazos sociales) OR (Arquitectura de relaciones sociales) OR (Arquitectura de vínculos sociales) OR (Red comunitaria de salud) OR (Red de salud de la comunidad) OR (Redes comunitarias de salud) OR (Redes de atención comunitaria) OR (Redes de salud comunitaria)) (All Fields) AND ((Atención Primaria de Salud) OR (Asistencia Primaria) OR (Atención Básica) OR (Atención Primaria) OR (Primer Nivel de Atención)) (All Fields) NOT ((Adulto Joven) OR (Adulto) OR (Niño) OR (Preescolar) OR (Recién Nacido) OR (Lactante) OR (Persona de Mediana Edad)) (All Fields) |
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((Adolescent*) OR (teen*) OR (Teenager*) OR (Youth*)) (All Fields) AND ((Social Support*) OR (Social Care) OR (Perceived Social Support*) OR (Community Support) OR (Family Support*) OR (Family Encouragement*) OR (Family Assistance*) OR (Psychosocial Support*) OR (Social Determinants of Health) OR (Health Social Determinant*) OR (Structural Determinants of Health) OR (Health Structural Determinant*) OR (Community Network*) OR (Community Care) OR (Community Health Network*)) (All Fields) AND ((Primary Healthcare) OR (Primary Health Care) OR (Primary Care)) (All Fields) NOT ((Adult) OR (Child) OR (Preschool) OR (Infant) OR (Newborn) OR (Middle Aged) OR (Children) OR (Young) OR (Disease)) (All Fields) |
Figure 2 - Preliminary search strategy used on Web of Science. Macapá, AP, Brazil, 2024
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Database |
Search strategy |
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Scopus |
(TITLE-ABS-KEY (adolescente* OR adolescência OR jove* OR juventude) AND TITLE-ABS-KEY (determinantes sociais da saúde OR determinante de saúde OR determinantes estruturais da saúde OR determinantes sociais de saúde OR apoio social OR parceiro social OR suporte social OR redes comunitárias OR arquitetura de laços sociais OR arquitetura de relações sociais OR arquitetura de vínculos sociais OR rede de assistência comunitária OR rede de cuidado comunitário OR rede de saúde comunitária OR rede de saúde da comunidade) AND TITLE-ABS-KEY (atenção primária à saúde OR atendimento básico OR atenção básica OR atendimento primário de saúde OR cuidado de saúde primário OR cuidados primários OR cuidados de saúde primários) NOT TITLE-ABS-KEY (adulto OR adulto jovem OR pré-escolar OR recém-nascido OR lactente OR pessoa de meia-idade)) |
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(TITLE-ABS-KEY (Adolescente OR Adolescencia OR Joven OR Jóvenes OR Juventud) AND TITLE-ABS-KEY (Determinantes Sociales de la Salud OR Determinante de salud OR Determinantes estructurales de la salud OR Apoyo Social OR Aliados Sociales OR Soporte Social OR Redes comunitarias OR Arquitectura de lazos sociales OR Arquitectura de relaciones sociales OR Arquitectura de vínculos sociales OR Red comunitaria de salud OR Red de salud de la comunidad OR Redes comunitarias de salud OR Redes de atención comunitaria OR Redes de salud comunitaria) AND TITLE-ABS-KEY (Atención Primaria de Salud OR Asistencia Primaria OR Atención Básica OR Atención Primaria OR Primer Nivel de Atención) AND NOT TITLE-ABS-KEY (Adulto Joven OR Adulto OR Niño OR Preescolar OR Recién Nacido OR Lactante OR Persona de Mediana Edad)) |
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( TITLE-ABS-KEY ( adolescent* OR teen* OR teenager* OR youth* ) AND TITLE-ABS-KEY ( "Social Support*" OR "Social Care" OR "Perceived Social Support*" OR "Community Support" OR "Family Support*" OR "Family Encouragement*" OR "Family Assistance*" OR "Psychosocial Support*" OR "Social Determinants of Health" OR "Health Social Determinant*" OR "Structural Determinants of Health" OR "Health Structural Determinant*" OR "Community Network*" OR "Community Care" OR "Community Health Network*" ) AND TITLE-ABS-KEY ( "Primary Healthcare" OR "Primary Health Care" OR "Primary Care" ) AND NOT TITLE-ABS-KEY ( adult OR child OR preschool OR infant OR newborn OR "Middle Aged" OR children OR young OR disease ) ) |
Figure 3 – Preliminary search strategy used on Scopus. Macapá, AP, Brazil, 2024
In addition, descriptors are also used in the databases Portal de Periódicos CAPES, Catálogo de Teses e Dissertações CAPES, PubMed, and EMBASE (Figure 4).
Figure 4 – Search strategy for the other databases. Macapá, AP, Brazil, 2024
Selection, extraction, and analysis of the evidence
After searching the selected databases, studies will be exported to Rayyan software, and duplicates will be removed. The remaining studies will undergo abstract and full-text reading by two independent review authors to avoid bias and ensure the legitimacy of the proposed review. This will identify evidence that meets the established principles. In case of disagreement, another review author will be consulted.
To synthesize the information, a tool created by the review authors will be used to identify the title, author(s), year of publication, objectives, methodology, and key findings relevant to the review protocol.
Analysis and presentation of data
For the presentation of the results, a narrative approach will be used, supported by tables, figures, and graphs to facilitate visualization, with the documents included at the end of the scoping review, following the information contained in the extraction instrument. Thus, the specificities of the social and community support network of adolescents in PHC will be presented. In addition, a narrative synthesis of the recommendations and limitations of the studies will be provided to provide useful insights for future research on the topic.
The authors have declared that there is no conflict of interests.
REFERENCES
1. Peixoto MB, Knuth AG, Silva ICM, Hallal PC. Apoio social e prática de atividade física no lazer em adolescentes: um estudo de base populacional. Rev Bras Ativ Fís Saúde. 2019;24:1-8. https://doi.org/10.12820/rbafs.24e0103
2. Vasconcellos M, Veiga G. Prática de atividade física de escolares adolescentes e o apoio de pais, amigos e professores de educação física. Braz J Dev. 2022;8(5):36647-36660. https://doi.org/10.34117/bjdv8n5-260
3. Lopes R, Ribeiro L, Oliveira D. A saúde promovida por redes sociais e comunitárias de mulheres de baixa renda. Cad Saúde Pública. 2023 [cited 2023 set 20];39(7):e00218022. Available from: https://www.scielo.br/j/csp/a/WsNmS33xtHgBs9BbKSzsNqh/?format=pdf&lang=pt
4. Costa M, Viana T, Pinheiro P, Cardoso M, Barbosa L, Luna I. Determinantes sociais de saúde e vulnerabilidade às infecções sexualmente transmissíveis em adolescentes. Rev Bras Enferm. 2019;72(6):1595-600. http://dx.doi.org/10.1590/0034-7167-2018-0726
5. Ministério da Saúde (BR), Secretaria de Atenção à Saúde. Departamento de Ações Programáticas e Estratégicas, Coordenação-Geral de Saúde do Adolescente e do Jovem, Proteger e cuidar da saúde de adolescentes na atenção básica [Internet]. 2. ed. Brasília: Ministério da Saúde; 2018 [cited 2023 Jan 14]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/proteger_cuidar_adolescentes_atencao_basica.pdf
6. Aguiar F, Alves V, Mata N, Nemer C, Rodrigues D, Silva M, Pereira A, Calandrini T. Saúde sexual e reprodutiva do adolescente: estudo de validação. Revista Contribuciones a Las Ciencias Sociales. 2023;16(9):18145-18164. https://doi.org/10.55905/revconv.16n.9-256
7. Pereira A, Lopes J. Saúde sexual e reprodutiva de adolescentes: seria a gravidez a única questão a ser debatida? BIS. 2021;22(1). https://doi.org/10.52753/bis.v22i1.38596
8. Malta D, Minayo MCS, Cardoso LSM, Veloso GA, Teixeira RA, Pinto IV, et al. Mortalidade de adolescentes e adultos jovens brasileiros entre 1990 e 2019: uma análise do estudo carga Global de Doença. Cien Saude Colet. 2021;26(9):4069-4086. https://doi.org/10.1590/1413-81232021269.12122021
9. Ministério da Saúde (BR), Secretaria de Atenção à Saúde, Departamento de Atenção Básica. Política Nacional de Atenção Básica [Internet]. Brasília: Ministério da Saúde; 2017 [cited 2023 jan 14]. 110 p. (Série E. Legislação em Saúde). Available from: http://189.28.128.100/dab/docs/publicacoes/geral/pnab.pdf
10. Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis [Internet]. Adelaide: JBI; 2020 [cited 2023 Jan 10]. Available from: https://jbi-global-wiki.refined.site/space/MANUAL
Submission: 04-Mar-2023
Approved: 05-Feb-2024