The pre- and post-course assessments will only be used to help us determine the effectiveness of our programs. We thank you in advance for your participation and hope you enjoy the program.

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* 1. To allow us to link your pre- and post-course assessments, please fill in the last four numbers of your cell phone followed by the first two letters of your street name.

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* 2. Are you prescribing self-administered hormonal contraception under state protocol?

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* 3. Have you completed the required training for prescribing self-administered hormonal contraception under state protocol?

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* 4. How comfortable are you with the following?

  Extremely uncomfortable Somewhat uncomfortable Neither comfortable or uncomfortable Somewhat comfortable Very comfortable
Administration of 17-alpha-hydroxyprogestrone (17-OHP) via deep intramuscular injection
Administration of 17-OHP via subcutaneous autoinjector
Facilitating patient access to commercial 17-OHP
Counseling patients about the safety of aspirin use during pregnancy
Identifying patients who are candidates for aspirin use during pregnancy
Discussing postpartum contraception plans with pregnant patients
Determining which contraception methods are safe during postpartum and breastfeeding

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* 5. For a patient who is pregnant with a singleton pregnancy (one fetus) and has a prior history of preterm birth, at which gestational age window should 17-OHP injections be initiated?

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* 6. How frequently should 17OHP injections be administered for prevention of preterm birth?

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* 7. Antihypertensive therapy should be initiated for pregnant patients with what blood pressure?

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* 8. For which of the following risk factors would low-dose aspirin be recommended during pregnancy?

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* 9. What is the recommended minimum interpregnancy interval?

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* 10. Which of the following contraceptive methods would not be appropriate for a patient who is two weeks postpartum?

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* 11. Which of the following best describes your practice site?

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* 12. What is your current position?

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* 13. How many years have you been practicing as a pharmacist?

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* 14. Do you administer injections in your practice site?

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* 15. What is your gender?

Thank you for completing the pre-course assessment. We hope you enjoy the program.
 
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