ࡱ> 796Q bjbjYY .&;e;e     ;XWWWWW222$!Z 22  WWuuuj W Wuuu?W|>]Q (0X,"^"?" ?20b"u222S"222X"222222222 : 91 Institutional Review Board Research Proposal Template [Use this template for your proposal submission. Attach this completed template to your electronic submission form. Bracketed information provides instructions and should be deleted from your final proposal.] 1. Title of Proposal: 2. Principal Investigator (PI): 3. PI Department: 4. PI Contact Information: 5. Faculty Sponsor and Contact Information (if PI is a student): 6. Other Investigators (name, e-mail address, and if student, class year): 7. Date of this Submission: 8. Proposed Duration of the Project (indicate starting and ending dates): 9. Background Information and Research Questions/Hypotheses: [Provide a brief rationale for your study and your main research questions/hypotheses.] 10. Human Participants: A. Who are the participants? B. How many participants do you plan to have in your study? C. How will the participants be contacted or recruited? D. Will the participants be compensated for participating? If so, describe: 11. Procedures: [What will you ask the participants to do? Where will your research activities be carried out (be specific)? Be sure to include all supporting documentation, i.e., data collection instruments. Be very specific about your procedures and present them in easily understandable terms.] [Websurveys: If your procedure includes a websurvey, indicate the software program you will use. Websurveys should allow any question to be skipped (e.g., offer an I choose not to answer response or allow questions to remain unanswered while still continuing the websurvey). At the end of the survey, provide an option for participants to withdraw from the study without submitting their responses (e.g., submit answers now versus cancel, do not submit answers; see Informed Consent Guidelines. Websurvey software must use SSL encryption, and must be set up to collect data anonymously, i.e., without saving user names or IP addresses. If data are not collected anonymously, explain to the IRB the purpose of collecting identifying information and how confidentiality will be maintained.] 12. Consent: [How will the participant give consent to be in your research? Be sure to attach any consent forms/scripts you will use.] [Websurveys: Note that low-risk studies using websurveys to collect data may be eligible to use implied consent, such that completing and returning the survey indicates consent to participate. In those cases, it is acceptable for participants to be instructed to click on a link if they give their consent to participate in the study. When implied consent is used, a brief statement of how confidentiality and privacy will be handled must appear in a concise consent statement at the beginning of the survey.] 13. Risks and Debriefing: [If applicable, describe your plan to debrief participants. Is there deception involved in your study? What are the physical, psychological, or social risks of participating in the study? Are there any technical aspects of equipment that pose a potential hazard to participants? Privacy and Storage of Data: [Explicitly describe how you plan to store data and to protect participants privacy.] [Websurveys: Describe how you will protect participants identities and responses (e.g., using SSL encryption, not collecting IP addresses, instructing the participant to clear the cache and browser history to maintain their privacy after completing the survey, storing the data in a password protected database). See Informed Consent Guidelines for more information. The IRB recommends that researchers use the following statement: The researcher(s) has taken all reasonable measures to protect your identity and responses. For example, the data is SSL encrypted, it is stored on a password protected database, and IP addresses are not collected. These measures provide the very high level of security that is used by financial institutions, and it is very unlikely that your data could be accessed by anyone. However, e-mail and the Internet are not 100% secure. Therefore, we also suggest that you clear the computers cache and browser history to protect your privacy after completing the survey.] 15. 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