Project Title. Name of Fellow Primary Mentor Additional Mentors Fellowship Site

Similar documents
Application Checklist for Expedited or Full Review

- STATEMENT OF WORK - Task Authorization (TA) 20 FOR SUBCONTRACT WITH CIMVHR PLEASE NOTE, THIS SUB CONTRACT HAS A SECURITY REQUIREMENT

Harvard University. Guidelines for Federal Sponsored Expenditures

Investigator Initiated Studies (IIS) Program Information Needed for Your Application

Second-Year Funding Request

Québec Reliability Standards Compliance Monitoring and Enforcement Program (QCMEP) October 10, Effective date: To be set by the Régie

Clemson University Financial Conflict of Interest Policy for PHS/NIH Supported Research

APPENDIX A FORM A PROTOCOL FOR RESEARCH INVOLVING HUMAN SUBJECTS. Department/College:

LEO Pharma Global Methodological Note to EFPIA HCP/HCO Disclosure Requirements

Johns Hopkins University. Policy on Individual Financial Interests and Financial Conflict of Interests 1, 2 in Research

Full Proposal Application Form

ST/SGB/2018/3 1 June United Nations

INSTITUTIONAL REVIEW BOARD FOR PROTECTION OF HUMAN SUBJECTS INFORMATION AND GUIDELINES FOR PROPOSAL APPROVAL OR EXEMPTION

LEO Pharma Global Methodological Note to EFPIA HCP/HCO Disclosure Requirements

HARVARD UNIVERSITY. Guidelines for Federal Sponsored Expenditures

UAMS ADMINISTRATIVE GUIDE NUMBER: 2.1

Template for essential information to be provided for proposals including clinical trials / studies / investigations. Version 1.

For questions regarding the completion of the application, please contact Dr. Robert Laird at or by

FP6 Contract and Financial Reporting. The Basics for EC Consortia. Linda Polik Research Services

Administrative Guidelines

ALL LEO TRADEMARKS MENTIONED BELONG TO THE LEO GROUP

JKUAT RESEARCH GUIDELINES Format and Guidelines for Writing a Research Proposal ANNEX IV

Charging Directly to Sponsored Projects Costs that are Normally Considered Indirect

Methodological Note to HCP/HCO Disclosure Requirements in the LEO Group including specifications from LEO Pharma A/S Romania Repressentative Office

Office of Research Administration

IN THE GENERAL ASSEMBLY STATE OF. Appropriate Use of Preauthorization Act. Be it enacted by the People of the State of, represented in the General

MENTORED RESEARCH PROJECT DETAILED BUDGET REQUEST FORM

REGENERON PHARMACEUTICALS, INC. FINANCIAL CONFLICTS OF INTEREST POLICY FOR PHS-FUNDED RESEARCH

DATA SHARING AGREEMENT

NEPAD/Spanish Fund for African Women s empowerment

CONFLICTS OF INTEREST IN RESEARCH

Title: Previous Version(s): 8/01, 1/02, 6/06, 1/12, 4/12

JKUAT RESEARCH GUIDELINES. Format and Guidelines for Writing a Research Proposal ANNEX IV

An Expanded View of Informed Consent Requirements when Conducting Human Subjects Research. Dorean Flores, CIP and Meredith Burcyk CIP

UNEP/OzL.Pro.30/4/Add.1/Rev.1. United Nations Environment Programme

MARIE CURIE INTRA-EUROPEAN FELLOWSHIP FOR CAREER DEVELOPMENT

Iowa State University Sponsored Programs Costing Policy For Awards Subject to OMB Circular A-21 (2 CFR 220)

AUDIT CERTIFICATE GUIDANCE NOTES 6 TH FRAMEWORK PROGRAMME

Financial Conflict of Interest. V001 November 14, 2014

TERMS OF REFERENCE FOR AN EXPENDITURE VERIFICATION OF A GRANT CONTRACT - EXTERNAL ACTION OF THE EUROPEAN UNION -

Application date : 07/07/2014 Procedure for submitting a new clinical research project. Véronique Baudewyns

Coalition for Epidemic Preparedness Innovations. CEPI Cost Guidance Version:

AMERICAN CANCER SOCIETY, INC. FINANCIAL CONFLICT OF INTEREST POLICY FOR PROMOTING OBJECTIVITY IN RESEARCH

ARPIM HCP/HCO DISCLOSURE CODE

Wales Patient Access Scheme: Process Guidance

Methodology to assess the cost impact of PMB benefit definitions

MedTech Europe Code of Ethical Business Practice. Disclosure Guidelines

COMMISSION DECISION. of

or institution which in turn is a member of the International Federation of Accountants (IFAC).

MARIE CURIE INITIAL TRAINING NETWORK

Data and Specimen Repositories

DOCUMENT HISTORY. Supersedes / Replaces. Version Effective Date Summary of Changes 01 30JUN2016 New Methodological Note

Tip Sheet 25: Provisions in Contracts and Funding Agreements

RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC. (RFMH) FINANCIAL CONFLICT OF INTEREST POLICY

Scientific Research Projects (BAP) Coordination Unit Directives

Salary & Wages Fringe Benefits Equipment Travel Participant Support. BUDGET CATEGORIES (click on image to go to page)

1. Disclosure of Significant Financial Interest means an Investigator s disclosure of significant financial interests to Monmouth University.

Labour Protection Requirements for the Protection of Employees from the Risk Caused by Vibration in the Work Environment

Adolescents 360 Baseline Survey Request for Proposals (RFP)

ALLEGATO A ANNEX VII Special Conditions Grant Contract Expenditure Verification

University of Connecticut DIRECT AND INDIRECT COSTS OF FEDERAL GRANTS AND CONTRACTS. Policy CADS1 Date Issued: June 19, 1998 Updated December 26, 2014

Moffitt Cancer Center

To: Vice Chancellors, Deans, Administrative Staff, Department Heads, and Students.

A Guide to OIE Laboratory Twinning Projects

Gilead Transparency Reporting Methodological Note

PROJECT IMPLEMENTATION DOCUMENT NO.2 REPORTING TEMPLATES & E-TOOL

TruScholar Proposal Writing Workshop. Office of Student Research

Basics of Developing Study Budgets in Clinical Research

Export Control Guidelines

RESEARCH PROJECT PROPOSAL

Request for Proposals: Data Collection Services in Haiti

AUDIT CERTIFICATE WORKING NOTES 6 TH FRAMEWORK PROGRAMME

(Non-legislative acts) REGULATIONS

Response to the IFAC Part 2, SMO Self-Assessment Questionnaire

FACT SHEET. The Physician Payments Sunshine Act: CMS Proposed Rule

WSSCC, Global Sanitation Fund (GSF)

7-8 weeks before lead institution proposal routing deadline. 6 weeks before lead institution proposal routing deadline

Statistical annex. 1. Explanatory notes Background Data processing Types of data utilized Reported data Adjusted data Modelled data References

ANNEX 1 STRATEGIES BY NRRA TO DETECT ACTIONS, ACTIVITIES AND BEHAVIOURS THAT RESULT IN SSFFC MEDICAL PRODUCTS

The Marie Curie Actions FP7 Financial Guidelines

How to demonstrate foreign building compliance with drug good manufacturing practices

Standard MSKCC Agreement

Retroactive Expenses Costs incurred prior to the execution of the legal agreement with OCE will not be eligible.

University of New England Investigator Significant Financial Interest Disclosure Policy for Sponsored Projects Originally Adopted March 2005

Project costs have to be actually incurred due to the project implementation, in order to be considered as eligible costs.

Provisional agenda item 26.5 INO6X80 REPORTS OF THE JOINT INSPECTION UNIT. Report by the Director-General

Revision of the UNFCCC reporting guidelines on annual inventories for Parties included in Annex I to the Convention

Impacts: CLINICAL RESEARCH Last Revised: 02/10/2012 Subject: CLINICAL STUDY BUDGET FACILITATION & INITIATION POLICY

Great-West G R O U P. Long Term Disability Income Benefits. Employee s Statement

Financial Disclosure Form for Investigators in PHS Research

University of California, San Francisco Helen Diller Family Comprehensive Cancer Center Policy and Procedure

Purchasing Procedures Manual

Payment Card Industry (PCI) Data Security Standard Validation Requirements

Clinical Trials Corporate Medical Policy

COMMISSION OF THE EUROPEAN COMMUNITIES. Proposal for a DIRECTIVE OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL

COLUMBIA UNIVERSITY INSTITUTIONAL REVIEW BOARD POLICY ON THE PRIVACY RULE AND THE USE OF HEALTH INFORMATION IN RESEARCH

This policy has been adapted from the Conflict of Interest in Research Policy at Tufts University.

REQUEST; PROPOSED INFORMATION COLLECTION ACTIVITY; COMMENT REQUEST; PROPOSED PROJECT

STATE UNIVERSITIES RETIREMENT SYSTEM OF ILLINOIS

Intellectual Property Policy

Transcription:

Project Title Name of Fellow Primary Mentor Additional Mentors Fellowship Site Date of Submission Fellow s phone number Fellows email Fellowship in Family Planning Research Proposal Outline Page 1

PROJECT SUMMARY The project summary should contain the most important aspects of the project, which may be extracted from the description of the project. It should be written after the remainder of the proposal is completed. The project summary should be a maximum of one page and must include the following: Justification for the project. State why the project is important. Proposed research. Outline briefly the information requested under the sections 1.1 through 1.3, including the hypothesis(es) to be tested. State the proposed study design. New features. Indicate the most relevant differences, either in methodology or outcomes, between the proposed investigation(s) and studies already published. Problems anticipated. Identify any scientific, ethical, or management problems that you expect may arise during the course of the project. 1. DESCRIPTION OF THE PROJECT The description should include sufficient detail to enable reviewers to assess the proposal. Describe fully all methods and procedures and give details of any substantive differences from published methods. List references at the end of the section. Biomedical research protocols involving human subjects or the use of human biological materials should follow the format shown below. For research projects involving humans in areas of science other than biomedicine (e.g., epidemiology, social and behavioural sciences) and for those not involving human subjects or materials, the format shown may have to be modified depending on the type of study. But even in those cases deviation from the format provided should be the minimum possible. 1.1 Rationale and objectives of the study 1.1.1 Rationale Describe the rationale of the study within the context of present knowledge. If applicable, justify the proposed study in terms of its demographic, social, or (reproductive) health impact, and of its policy, service, or programme relevance. 1.1.2 Objectives and hypotheses List the main and subsidiary objectives of the study. Specify your research questions and hypotheses and state the variables and outcomes to answer those questions. Fellowship in Family Planning Research Proposal Outline Page 2

1.2 Previous similar studies Describe briefly the most relevant studies published, drawing upon systematic reviews where these exist. If a systematic review does not exist, a thorough review of relevant literature should be presented. 1.3 Design and methodology 1.3.1 Research design and General Methodological Approach Provide an overview of the research design, including a justification for choice in study design in relation to the objectives of the project. Provide a brief outline of the most important features of the study, such as the nature of the study, number and main characteristics of subjects involved, number and frequency of follow up visits, and investigations that will be undertaken. 1.3.2 Criteria for the selection of subjects Describe the population that will constitute the source of subjects for the study sample and justify its selection in relation to the objectives of the study. Specify the characteristics required for participation in the study (inclusion criteria) and those that exclude a potential subject from participating (exclusion criteria). If applicable, discuss the selection of comparison groups and matching criteria, and/or describe the sampling procedures, including the type of sample (e.g., quota, simple random, stratified random, and cluster). Discuss how the potential respondents will be approached. When the proposed research requires the use of hospital or other records, provide evidence that you have the permission of the concerned authorities to use the records. If existing data are to be used for secondary analyses, provide evidence that the data will be available, and that there are no restrictions on the dissemination of the eventual findings of the study. 1.3.3 Subject recruitment and allocation Indicate where, how and by whom the subjects will be recruited. Describe the size and characteristics of the population from which the subjects will be recruited and any permissions needed to recruit them. Copies of any written materials and transcripts of any verbal messages advertising the study should be attached to the proposal. If applicable, describe the type(s) and method(s) of allocation of subjects to index and comparison groups. State when this allocation will take place. 1.3.4 Description of the drugs and devices to be studied Fellowship in Family Planning Research Proposal Outline Page 3

For drugs and devices that are commercially available, give the proprietary names, chemical composition, amount of drug present per dose, and the names and address of the manufacturers. For drugs or devices used for the first time in humans, or drugs and devices that are still at an early stage of clinical study, or drugs that are generally available but will be administered by different routes or in different dosages, give the chemical composition of the drug, the source, and the amount per dose. Summarize the relevant pre clinical investigations in animals and describe the main pharmacological actions of the compounds. If available, give results of studies already conducted in humans. Also, provide the same information for any new vehicles used for the administration of the drugs. 1.3.5 Admission procedure Describe where, when, how and by whom recruitment to the study will be carried out. Describe the proposed procedures for admitting subjects to the study, including the timing of admission and/or allocation to study groups. Describe the data collected at admission and, if available, attach a copy of the admission form as an annex to the proposal. 1.3.6 Follow up procedure Describe the frequency and timing of follow up of subjects, the planned investigations and the data to be collected at each follow up visit. If available, attach copies of the forms to be used. Describe the procedures to be used in tracing subjects who do not comply with the follow up schedule. 1.3.7 Criteria for discontinuation Specify the conditions that would lead to discontinuation of a subject from the study or to the termination of the study, in whole or in part. 1.3.8 Laboratory and other investigations List the laboratory and other diagnostic and investigative procedures that will be carried out as part of the study and describe test characteristics. Important procedures i.e., those that are essential for the achievement of the objectives of the study and methods not previously published should be described in detail. For other procedures reference to appropriate published work would be sufficient. 1.3.9 Data management State what procedures will be used for data management, including data coding, monitoring, and verification. Also describe the administrative and computer procedures to be used, the type of staff available and whether any training will be needed to facilitate data management. Fellowship in Family Planning Research Proposal Outline Page 4

1.3.10 Data analysis Provide information on available computer facilities. Outline the statistical methods that will be used for the analysis of the data, including a description of how the information collected will be used to test the stated hypothesis(es) and how any missing data (e.g., items not applicable in a questionnaire, follow up losses, and subjects withdrawing from the study) will be dealt with. If relevant, the major subgroup analyses and/or comparisons between the study groups that are anticipated should be specified. For projects requiring special statistical techniques (life table analysis, multivariate analysis, logistic regression, etc.), describe how these will be used. If complex tabulations are planned, provide dummy tables. For projects involving qualitative approaches (focus group discussions, in depth interviews, observational techniques, etc.), specify in sufficient detail how they will be analysed. 1.3.11 Number of subjects and statistical power Describe and justify the assumptions underlying the estimates of prevalence and incidence rates for the main study objectives, the differences that the study is expected to detect and the power required to demonstrate such differences. The method of computation to be used in estimating the number of recruited subjects in each treatment group or at each center, or for calculating the number of controls per case should also be described or referenced. Adequate allowance must be made for measurement error and the estimated number of subjects expected to drop out before the study is completed and/or those that may have to be excluded from analysis. Explain the variability to be expected in the findings, and state what differences will provide significant results. Give the probability that such differences will be detected, at a stated level of statistical significance, by the planned experimental and statistical methods with the given numbers of subjects. 1.3.12 Study limitations Describe possible weaknesses or limitations in validity and generalizability of study results. List steps you have taken to limit these effects. 1.3.13 Duration of project Fellowship in Family Planning Research Proposal Outline Page 5

Provide information on the estimated time for the recruitment of study subjects, collecting samples/specimens, follow up of subjects, laboratory tests, data analysis, and for report writing. Please include estimated start and end dates for the project. It is recommended that this information be presented using the timeline template provided on the fellowship website, which can be modified as needed. A sample timeline is also provided on the website for your reference. The timetable should include months across the top and activities listed along the left margin. Activities in the case of social science projects, for example, include, pre tests, questionnaire development, training of staff or interviewers, data collection, data coding, data entry, analysis, and report writing. For each of the activities mark a cross against the month(s) in which they will occur. 1.4 Project management For collaborative projects involving several departments and/or institutions, indicate who will have overall responsibility for the project, which other departments (or institutions) will be involved and what their respective responsibilities will be, and the manner in which the work will be coordinated and monitored. Please identify the primary faculty mentor and additional mentors for the project in the section. 1.5 Links with other projects Indicate if the proposed project is linked in any way to other projects in progress. 1.6 Main problems anticipated Describe the main obstacles and difficulties which you expect might interfere with the successful completion of the project within the time and costs proposed. Discuss how these problems will be confronted. For studies involving a risk of unplanned pregnancy, indicate what advice and choice of management will be offered to the subjects. 1.7 Expected outcomes of the study and dissemination of findings Indicate how the study will contribute to advancement of knowledge, how the results will be utilized, and by what means they will be disseminated (e.g., thesis, scientific publication, workshop). If applicable, describe how the results are expected to affect health care policies and practices in areas such as reproductive health, family planning, abortion or population. 1.8 References Cite the pertinent literature in the text and provide the complete reference list in the References section. Provide complete bibliographical details for each reference: i.e., for Fellowship in Family Planning Research Proposal Outline Page 6

journal articles, full name(s), year of publication, full title, name of journal, volume number, and page numbers; for books, name(s) of authors(s), year of publication, full title, place of publication, and publisher; and for chapters in books, name(s) of author(s), year of publication, full title of the chapter, full title of the book, name(s) of editor(s), place of publication, publisher, and page numbers. 2. ETHICAL CONSIDERATIONS Ethical considerations For studies in humans (or involving human biological materials) evidence must be provided that the proposed research has been approved by the local, institutional or equivalent ethics committee. The Society of Family Planning Research Fund (SFP Research Fund) will not transmit any funds until such approval has been given. 2.1 Informed decision making and confidentiality A form must be provided with the proposal to indicate that the research subject has decided to take part in the study of her/his own free will. It should be written in the prospective subjects' mother tongue, and when this is not English, an English language translation should be provided as well. For multicenter studies, a common consent form will be taken as a minimum requirement, to which additions may be made as dictated by local circumstances. In such cases, the common consent form should be written in the mother tongue of the writer and translated into English and other languages as required. The consent form has two parts: (a) a statement describing the study and the nature of the subject's involvement in it; and (b) a certificate of consent attesting to the subject's consent. Both parts should be written in sufficiently large letters and in simple language so that the subject can easily read and understand the contents. As far as possible, medical terminology should be avoided in writing up the consent form. Fellowship in Family Planning Research Proposal Outline Page 7

3. BUDGET Budget Considerations The SFP Research Fund can only meet the costs specifically incurred by the institution for conducting the project. The SFP Research Fund cannot provide, as part of its project support, overhead, indirect costs, institution strengthening funds whether for equipment, supplies or training beyond the need of the specific project. In addition, conference expenses to present research findings are not covered by project funding. The budget must be itemized and fully justified. 3.1 Line Item Budget It is recommended that this information be presented using the budget template provided on the fellowship website, which can be modified as needed. A sample budget is also provided on the website for your reference. The line item budget should be included as a separate document from the proposal. Please provide a detailed description of expenses within each of the major budget categories. List each item and include price per unit and quantity. 3.2 Budget Justification The budget justification should be no more than 1 2 pages and should follow the categories identified in this section. Please describe the need for the expenses per budget category. This is a single justification for all budget years. Budget items must not include "miscellaneous" or "contingency" items or an overhead payment to the institution. Line Item Budget and Budget Justification categories include: A. Personnel This section should include the names of all personnel, including the principal investigator(s), mentor(s) and the fellow. Please describe the duties of all personnel, including the fellow. Principal Investigators (including co investigators and faculty mentors that are within and outside of the department) and Fellows salaries are in kind and not covered by project funding. A 5% cap on investigator salaries will be applied in cases of institutional salary mandates. Salary contribution for institutional collaborators (i.e. faculty from other departments) with more than 5% effort on the research project will be reviewed and finalized by the National Office. Salaries for supporting personnel such as research assistants or interviewers should be included and justified. Consultant services should be included in F. Other Costs. Fellowship in Family Planning Research Proposal Outline Page 8

B. Equipment Allowable items ordinarily will be limited to research equipment and apparatus not already available for the conduct of the project. List each item of equipment separately and justify each in this section. General purpose equipment, such as a personal computer, is not eligible for support unless primarily or exclusively used in the actual conduct of the research project. C. Materials and Supplies This section includes: office supplies, pharmaceuticals, laboratory items, computer software, etc. Indicate general categories such as glassware, chemicals, animal costs, including an amount for each category. D. Participant Costs This section includes: participant incentives, office visits of study participants, etc. Please provide a detailed description of these expenses. E. Travel In this section, enter the total funds requested for domestic travel and foreign travel. Domestic travel includes Canada, Mexico, and US possessions. Foreign travel includes any travel outside of North America and/or US possessions. In this section include the purpose, destination, dates of travel (if known), and number of individuals for each trip. If the dates of travel are not known, specify estimated length of trip (for example, 3 days). F. Other Costs This section includes project expenses related to shipping/postage, telephone, copying/printing and advertisement. Also included in this section are: consultant services, translation and transcription services, and any other contractual costs directly related to the project. Consultant Services In this section identify each consultant, the services he or she will provide, the total number of days, travel costs, and the total estimated costs. Please provide the names and organizational affiliations of all consultants. Consultant service fees exceeding $5000 will be reviewed and finalized by the National Office. Contractual Costs Enter the total contractual costs for support services, such as the laboratory testing of biological materials or clinical services. 4. APPENDICES All appendices, other than the line item budget and timeline, should be included at the end of the proposal Word document and listed here as: Appendix A: Title Appendix B: Title Fellowship in Family Planning Research Proposal Outline Page 9