IRB Comment Form
RESEARCH PROJECT DESCRIPTION
1. Purpose of the Study:
E.g. : It sounds good.
2. Rationale for the Study:
3. Research Question or Hypothesis(es):
4. Research Design:
5. Describe in Detail the Data Collection Procedure:
6. Plan for Data Analysis:
SAMPLING METHOD AND PARTICIPANT REQUIREMENTS:
1. What sampling method will be utilized?
2. Affiliation of Participants:
3. Participant Characteristics - Provide required narrative:
4. What are the participants expected to do?
5. Length of Time Required from Participants:
6. Setting for Data Collection:
INFORMED CONSENT/ASSENT PROCEDURES:
Please mark an X in the appropriate box(es)
1. Will this study seek consent from participants?
[ ] Yes [ ] No
2. What type of document(s) will be used to obtain consent?
[ ] Signed consent form [ ] Parental Consent Form
[ ] Letter of Consent [ ] Child Assent
[ ] Other___________________
Specify
3. Is there any reason why consent will not be sought? Explain why and what procedure you will use to ensure the participant understands in order to guarantee his or her rights.
[ ] Yes, please explain [ ] No
INSTRUMENTS, QUESTIONNAIRES AND QUALITATIVE DATA COLLECTION
1. Which of the following will be used to collect data:
[ ] Instrument(s)
[ ] Sociodemographic Questionnaire(s)
[ ] Focus Group Discussions
[ ] Interview(s)
[ ] Field notes
[ ] Other__________________________________
Specify
2. Provide the name of any instrument(s) being used and a citation/reference:
3. For qualitative studies, what will you be asking participants?
4. Feedback: What information will be provided to participants concerning their test results?\
5. If conducting an experiment, please describe in detail the manipulation being used.
DATA COLLECTION AND CONFIDENTIALITY
1. Please indicate if you will use any/all of the following:
[ ] Audio recording
[ ] Video recording [ ] Other________________
[ ] N/A Specify
2. What procedure(s) will you use to ensure confidentiality of the data?
3. Will identification numbers be assigned to each participant and used on data collection forms to protect the participant(s) responses?
[ ] Yes [ ] No
If Yes, who will assign the identification numbers? _____________________________
4. Who will have access to the list that identifies participants and the assigned identification numbers?
5. Where, how and how long will the data from the study be stored?
RISKS TO RESEARCH PARTICIPANTS
1. Immediate Risks:
2. Long-Range Risks:
3. If there are immediate or long-term risks to the participant, how will you mitigate these risks?
BENEFITS TO RESEARCH PARTICIPANTS
1. Describe any benefits participants may receive as part of volunteering in your study.
2. Will participants be compensated for their time? [ ] Yes (please explain) [ ] No
DECEPTION
If no deception will be used, Please mark an X and skip to section L. [ ]
1. Will you be utilizing deception?
[ ] Yes [ ] No
2. What is the nature of the deception involved?
3. Why is this deception necessary?
DEBRIEFING
1. Will you debrief participants?
[ ] Yes [ ] No
2. How will debriefing take place?
Final Decision
Do the potential benefits exceed the potential costs of participating in this research?
Make a decision about the IRB application under review:
[ ] Not Approved: [ ] Approved