Succeeding in the Management of Heart Failure: The Evolving Role of the Family Practitioner Evaluation (ID: i724a) Survey

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* 1. Following your participation in this activity, how confident are you in the management of patients with HF in your practice?

Very confident

Confident

Neutral

Little confidence

No confidence

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* 2. How committed are you to making changes in your practice based on your participation in this activity?

Very committed

Committed

Neutral

Not committed

I do not plan to make changes

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* 3. How many patients with HF do you currently manage in your practice? Please respond with your best approximate number.

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* 4. How many years have you been in practice?

1-10

11-20

>21

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* 5. As a result of participating in this activity, will you change components of your communication with patients with HF? If so, please describe changes.

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* 6. Which of the following best describes the impact of this activity on your performance?

I gained new strategies/skills/information that I can apply to my area of practice

I need more information before I change my practice behavior

This activity will not change my practice, as my current practice is consistent with the information presented

This activity will not change my practice, as I do not agree with the information presented

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* 7. After participating in today’s activity, I am now able to:

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree
Describe primary care clinicians’ role in the monitoring, follow-up, and post-hospital discharge management of patients with HF	Describe primary care clinicians’ role in the monitoring, follow-up, and post-hospital discharge management of patients with HF Strongly agree	Describe primary care clinicians’ role in the monitoring, follow-up, and post-hospital discharge management of patients with HF Agree	Describe primary care clinicians’ role in the monitoring, follow-up, and post-hospital discharge management of patients with HF Neutral	Describe primary care clinicians’ role in the monitoring, follow-up, and post-hospital discharge management of patients with HF Disagree	Describe primary care clinicians’ role in the monitoring, follow-up, and post-hospital discharge management of patients with HF Strongly disagree
Identify key components for the diagnosis of HF	Identify key components for the diagnosis of HF Strongly agree	Identify key components for the diagnosis of HF Agree	Identify key components for the diagnosis of HF Neutral	Identify key components for the diagnosis of HF Disagree	Identify key components for the diagnosis of HF Strongly disagree
Individualize HF treatment based on patients’ clinical presentation and in alignment with the latest evidence-based guideline recommendations for management	Individualize HF treatment based on patients’ clinical presentation and in alignment with the latest evidence-based guideline recommendations for management Strongly agree	Individualize HF treatment based on patients’ clinical presentation and in alignment with the latest evidence-based guideline recommendations for management Agree	Individualize HF treatment based on patients’ clinical presentation and in alignment with the latest evidence-based guideline recommendations for management Neutral	Individualize HF treatment based on patients’ clinical presentation and in alignment with the latest evidence-based guideline recommendations for management Disagree	Individualize HF treatment based on patients’ clinical presentation and in alignment with the latest evidence-based guideline recommendations for management Strongly disagree
Employ motivational interviewing to encourage patients to take an active role in disease management	Employ motivational interviewing to encourage patients to take an active role in disease management Strongly agree	Employ motivational interviewing to encourage patients to take an active role in disease management Agree	Employ motivational interviewing to encourage patients to take an active role in disease management Neutral	Employ motivational interviewing to encourage patients to take an active role in disease management Disagree	Employ motivational interviewing to encourage patients to take an active role in disease management Strongly disagree

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* 8. Keith C. Ferdinand, MD, effectively:

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree
Presented the material	Presented the material Strongly agree	Presented the material Agree	Presented the material Neutral	Presented the material Disagree	Presented the material Strongly disagree
Avoided commercial bias	Avoided commercial bias Strongly agree	Avoided commercial bias Agree	Avoided commercial bias Neutral	Avoided commercial bias Disagree	Avoided commercial bias Strongly disagree

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* 9. Javed Butler, MD, MPH, MBA, effectively:

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree
Presented the material	Presented the material Strongly agree	Presented the material Agree	Presented the material Neutral	Presented the material Disagree	Presented the material Strongly disagree
Avoided commercial bias	Avoided commercial bias Strongly agree	Avoided commercial bias Agree	Avoided commercial bias Neutral	Avoided commercial bias Disagree	Avoided commercial bias Strongly disagree

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* 10. The content presented:

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree
Enhanced my current knowledge base	Enhanced my current knowledge base Strongly agree	Enhanced my current knowledge base Agree	Enhanced my current knowledge base Neutral	Enhanced my current knowledge base Disagree	Enhanced my current knowledge base Strongly disagree
Addressed my most pressing questions	Addressed my most pressing questions Strongly agree	Addressed my most pressing questions Agree	Addressed my most pressing questions Neutral	Addressed my most pressing questions Disagree	Addressed my most pressing questions Strongly disagree
Promoted improvements or quality in health care	Promoted improvements or quality in health care Strongly agree	Promoted improvements or quality in health care Agree	Promoted improvements or quality in health care Neutral	Promoted improvements or quality in health care Disagree	Promoted improvements or quality in health care Strongly disagree
Was scientifically rigorous and evidence based	Was scientifically rigorous and evidence based Strongly agree	Was scientifically rigorous and evidence based Agree	Was scientifically rigorous and evidence based Neutral	Was scientifically rigorous and evidence based Disagree	Was scientifically rigorous and evidence based Strongly disagree

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* 11. What barriers do you see to making changes in your practice?

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* 12. Please list any clinical issues/problems within your scope of practice you would like to see addressed in future educational activities:

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* 13. If you indicated that you perceived commercial bias or influence, please describe:

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* 14. If you would like to participate in a text-message based Mobile Coach activity related to the content of this program, please provide your mobile number below.

Mobile Coach follow-up platform reinforces education following primary activity.

Mobile Coach utilizes an intelligent chatbot to deliver responsive text message conversations to participants.

Following enrollment, participants will receive 1-3 text messages a week for a period of 8 weeks.

Text messages are sent at varied times during the day and consist of informational reminders, mechanisms for goal setting in the next week, and interactive questions.

You may opt out at any time.

Yes, I would like to participate in the text-based Mobile Coach activity.

Mobile Phone: