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The significant interplay of enabling contextual factors and the generative mechanisms operating in the primary care practice environment is presented in context of existing research and proposed future developments. To describe the use of and adherence to 17-alpha hydroxyprogesterone caproate (17-OHPC), explore factors associated with its utilization and adherence, and to investigate the outcomes of 17-OHPC in a real-world setting. The Decision Resources Group (DRG) database (1 January 2012-31 December 2017) was used to identify women w