Clinical/Community Research and Integration Support Program (CRISP)

Clinical/Community Research and Integration Support Program (CRISP)

2017 Application Instructions

Application Deadline September 12, 2017 at 4:00pm

Research Grants Administration, 4-081 ECHA, University of Alberta, Edmonton, T6G 1C9

This funding opportunity is intended to fund clinical and/or community research that has the potential to improve health outcomes and/or influence clinical practice at the point of care for women and/or children.

Funding requests up to $20,000 (total) for a three year term will be considered.

Complete eligibility criteria is provided in the program guidelines however applications should note, that all principal investigators must be eligible to hold research funds according to the UAPPOL policy.

WCHRI defines a principal investigator as an individual who will:

·  be responsible for the direction of the proposed activities;

·  assume the administrative and financial responsibility for the grant or award; and

·  receive all related correspondence.

WCHRI defines a co-investigator as an individual who contributes to completing the proposed research activities.

WCHRI defines a research mentor as an individual who will share knowledge willingly and provide advice at all phases of the research project (proposal development, ethics submission, data collection, data analysis, dissemination/implementation of findings).

WCHRI defines a collaborator as an individual whose role in the proposed activities is to provide a specific service or resource (e.g., access to equipment, space, or a patient/community population; training in a specialized technique, such as statistics or qualitative methods). Where a letter of support is required, applicants are encouraged to refer to the CIHR resource Writing Letters of Support.

Note: Department of Pediatrics applicants must contact Dr. Gary Lopaschuk, associate chair, research by July 12, 2017 for support with the application process and internal review.

Application Relevance to WCHRI’s Vision, Mission, and Strategic Roadmap

All applications submitted must align with WCHRI's vision, mission and strategic roadmap and meet our relevance criteria. Applications that do not present with clear alignment and relevance will not be eligible to hold WCHRI funds (other eligibility criteria must also be met).

Vision: To harness the power of research innovation for a healthy future for children and women

Mission: WCHRI will foster the brightest minds to discover, innovate and ultimately transform the health of children and women through supporting research excellence.

WCHRI’s Strategic Roadmap: WCHRI has developed a five-year (2015-2020) strategic roadmap to focus our support for women and children's health research for maximum impact. The roadmap was created after extensive consultation with our members, partners and funders, and builds upon our past successes. The plan focuses on four strategic areas:

1.  Research-integrated hospitals and communities: Improve health outcomes for children and women through research embedded at the point of care.

2.  Children's health and well-being: Identify effective treatments to address the unique health needs of children; improve our understanding of rare and complex childhood diseases.

3.  Healthy development: Optimize maternal and infant health outcomes; develop early intervention and prevention strategies to reduce the risk for lifelong chronic disease.

4.  Lifelong women's health: Support research that addresses mechanisms related to the unique health needs of women; improve reproductive health outcomes.

To establish relevance all CRISP applications must clearly address the following:

·  The primary research question must be directly relevant to women and/or children’s health;

·  The research question should describe outcomes with potential benefit to our partner hospitals (Stollery Children’s Hospital and/or Lois Hole Hospital for Women);

·  Methodology, including details of study design, sufficient to demonstrate potential to rapidly change care and/or improve health outcomes.

Applicants should note that the above are some common considerations; alternative or additional factors may need to be included depending upon the proposed research. All applications will be screened for relevance as follows:

Project Relevance and Alignment
Somewhat relevant to WCHRI
Moderately relevant to WCHRI
Highly relevant to WCHRI

Instructions for Completion of Application Form

·  Review reference materials (application form, guidelines, and checklist) provided on the WCHRI website before you start filling out the application form.

·  Do not submit the application or any supporting documentation by email. Only printed (hardcopy) applications and solicited supporting material will be accepted.

·  Do not submit photo-reduced, double-sided or stapled application material(s).

·  Do not exceed the space provided. Additional pages may be provided only where indicated and must be provided in Arial 10 pt font size. All margins are restricted to no less than 2 cm. In each additional page, the applicant’s name must be provided in the header and the page number provided in the footer (e.g. page 7a, 7b, 7c, etc…).

·  Only a current application form will be accepted for this competition. Applications may be subject to administrative amendment and/or submitted to the peer review committee as is. It is the applicant’s responsibility to ensure the application is accurate and complete at the time of submission.

The application package must be received by WCHRI on, or before, the deadline with all of the information below:

·  A complete original, signed application form with your research proposal attached,

·  Complete the biosketch (see template), and if applicable:

o  Signed letter(s) of mentor support.

o  Signed letter(s) of stakeholder and/or community engagement.

o  Signed letters from each collaborator (as appropriate).

o  Supporting documentation for the Summary of Other Funding section.

Application Deadline

Applications must be received by the WCHRI Grants Administration Office, located at 4-081 Edmonton Clinic Health Academy (ECHA), 11405 – 87 Avenue, not later than September 12, 2017 at 4:00 pm. Late applications will not be accepted.

Evaluation Procedure

All eligible applications will be reviewed by 2 committee members who are academic faculty members. Consider that your reviewers may not necessarily be experts in your area of research interest when developing your application. All application feedback will be provided to the principal investigator. All application or award management remains the responsibility of the principal investigator; this includes notification of the research team of the application outcome.

Competition Results

All applicants will be notified of the results by email. Successful applicants will be posted on the WCHRI website.

Clinical/Community Research and Integration Support Program (CRISP)

2017 Application Form

Application Deadline: September 12, 2017 at 4:00pm

Submit this completed (printed) and signed full application with all supporting documentation to:

Research Grants Administration, 4-081 ECHA, University of Alberta

PERSONAL INFORMATION

Name of Principal Investigator: Last Name, First Name, Middle Initial(s)

WCHRI SUPPORT OF RESEARCH AND SCHOLARSHIP PRACTICE AND BEHAVIOUR

WCHRI supports the University of Alberta’s efforts to ensure the highest standards of research and scholarship practice and behavior. By signing below, each candidate asserts that this application adheres to all research policies and procedures in place at the University of Alberta. WCHRI reserves the right to request institutional confirmation of assertions contained within this application.

Misrepresentations of authorship, credentials or research support may result in disqualification of the candidate from this competition. Further actions may include: disqualifying the candidate from future competitions for a time period determined solely by WCHRI, withdrawal of any remaining installments of support for any existing WCHRI grant or award for which misrepresentation appears in the submission, and seeking partial or full repayment of any past financial support under any WCHRI grant or award for which misrepresentation appears in the submission.

Further information on research and scholarship integrity, the University of Alberta’s governance policies may be found at: https://policiesonline.ualberta.ca

SIGNATURES

The undersigned agree to abide by UAPPOL and the general policies and guidelines governing any award made pursuant to the sponsorship of this application.

Required Signatures / Printed Name / Date (dd/mm/yy)
Principal Investigator / dd/mm/yy
Department Chair / dd/mm/yy
Faculty Dean / dd/mm/yy
Research Services Office / dd/mm/yy

NAME OF PRINCIPAL INVESTIGATOR: Last Name, First Name

PRINCIPAL INVESTIGATOR’S CONFIRMATION OF WCHRI MEMBERSHIP: YES NO

If you are not a member, please complete membership at http://www.wchri.org/membership before submitting this application.

MENTORSHIP AND RESEARCH TEAM SUMMARY

List the individuals who will form the research team. For individuals not employed or affiliated with the University of Alberta, please indicate their organizational affiliation (e.g. Alberta Health Services, Covenant Health, Primary Care Network, clinical or community-based organization, other University).

RESEARCH MENTORSHIP

All applicants are encouraged to include a mentor on the research team. If you have less than 40% protected research time you MUST include a Mentor on your research team. A letter of mentor support is required for each nominated mentor. See CRISP Information for Mentors on the website.

Primary Research Mentor

Name / Last Name, First Name, Middle Initial(s)
Department/Faculty / University or Organization

Research Mentor – if applicable

Name / Last Name, First Name, Middle Initial(s)
Department/Faculty / University or Organization

LETTER OF MENTOR SUPPORT

A letter of mentor support is required for all applicants whose applications include a mentor on the research team. The letter must be signed by the mentor, be currently dated and on appropriate letterhead.

The focus and/or primary task for the Research Mentor is ensuring that the project remains on time and on task as defined in the application (specifically in the Research Proposal, Work Plan and KT plan sections). In addition, Mentors are asked to specifically detail:

·  The Mentor’s engagement in the development of this research proposal, and

·  The Mentor’s commitments (feedback, meetings, contributions to overall research direction, etc.) to foster/ support the Principal Investigator’s engagement in research.

Principal Investigator: Last Name, First Name

RESEARCH TEAM MEMBER

Co-investigator - if applicable

Name / Last Name, First Name, Middle Initial(s)
Department/Faculty / University or Organization
Signature:

Co-investigator - if applicable

Name / Last Name, First Name, Middle Initial(s)
Department/Faculty / University or Organization
Signature:

Co-investigator - if applicable

Name / Last Name, First Name, Middle Initial(s)
Department/Faculty / University or Organization
Signature:

Co-investigator - if applicable

Name / Last Name, First Name, Middle Initial(s)
Department/Faculty / University or Organization
Signature:

The roles and responsibilities for each Co-investigator must be detailed in the Research Proposal. Additional documentation and/or letters from Co-investigators are not required and will not be provided to committee for review.

Principal Investigator: Last Name, First Name

RESEARCH TEAM MEMBER

Collaborator 1 - if applicable

Name / Last Name, First Name, Middle Initial(s)
Department/Faculty / University or Organization

Collaborator 2 - if applicable

Name / Last Name, First Name, Middle Initial(s)
Department/Faculty / University or Organization
Name / Last Name, First Name, Middle Initial(s)
Department/Faculty / University or Organization

Collaborator 3 - if applicable

LETTERS OF COLLABORATION

Letters of collaboration from each collaborator must be submitted with this application and should clearly detail the individual’s involvement and role in the proposed research project.

Each letter of collaboration must be signed by the collaborator making the commitment, be currently dated and on appropriate letterhead.

ADDITIONAL LETTERS OF SUPPORT

LETTERS OF STAKEHOLDER AND/OR COMMUNITY ENGAGEMENT

Projects that require a commitment of resources (staff time, equipment, community engagement, etc...) from a sponsoring/ supporting agency, organization, service, association must provide a letter that outlines the commitments to the project. Letters must be currently dated, on letterhead that represents the supporter/ stakeholder sponsoring affiliation, and signed by the sponsor.

Principal Investigator: Last Name, First Name

SUPPORTING DOCUMENTATION

BIOSKETCH

Append a biosketch (see template) for the Principal Investigator, for each Research Mentor and each Co-investigator.

PROTECTED TIME FOR RESEARCH

All applicants are expected to have protected time for research to undertake this this research. While all applicants are encouraged to include a mentor on the research team, note that if you have less than 40% protected research time you MUST include a project mentor on your research team.

What is your formal time protection for research/ scholarship according to your job description (provide this time allocation as a percentage) / %

LOCATION OF PROPOSED RESEARCH

Please provide a brief description of the location where the research will be taking place – if patient oriented or community-based research, please indicate the clinical or community setting (e.g. 2E Stollery Ambulatory Clinic, Maternal-Fetal-Medicine Clinic, North East Community Health Centre, etc.)

Department/Faculty, Hospital, Clinic, Community, or other
Room Number and Building (if applicable)

ETHICS INFORMATION

Indicate whether the proposed research requires the following ethical approvals. The principal investigator is responsible for ensuring that applications have received appropriate ethics, animal certification or biohazards approval. While WCHRI does not require this documentation, evidence of approval(s) must be in place in order for RSO to release funding. Please note that ethics approvals must list WCHRI as the funder.

Human Subjects (HREB) / Approved / In Process / Not required
Biohazard Certification - Level / Approved / In Process / Not required
Biological and Genetic Therapeutics Directorate (Health Canada) Approval / Approved / In Process / Not required
AHS Administrative Approval / Approved / In Process / Not required

Principal Investigator: Last Name, First Name

RESEARCH RELEVANCE

Please indicate below whether this proposal aims to change care or improve outcomes for children and/or women. For research that proposes outcomes for both women and children, select both checkboxes.

CHILDREN’S HEALTH WOMEN’S HEALTH

RELEVANCE TO WOMEN AND/OR CHILDREN’S HEALTH

In the space provided below, detail the relationship of the proposed research to women’s and/or children’s health and relevance (direct or indirect) to the Stollery Children’s Hospital and/or Lois Hole Hospital for Women.

LAY TITLE AND SUMMARY

In the space provided below, provide a non-technical title and summary of your research. This title and abstract may be released to our stakeholders and funders and should be written in simple, clear language suitable for a lay audience.

Principal Investigator: Last Name, First Name

WORK PLAN

List the main tasks involved in the completion of the research project. Estimate the work end date for each listed item. The period of support for this grant is three (3) years; All proposed activities must take place within the period of support. Additional pages may be used.

Milestones / Work Start Date / Work End Date
Participant recruitment (if applicable) / dd/mm/yy / dd/mm/yy
Data collection / dd/mm/yy / dd/mm/yy
Data analysis / dd/mm/yy / dd/mm/yy
Review and interpretation of findings / dd/mm/yy / dd/mm/yy
Manuscript preparation (or other KT output) / dd/mm/yy / dd/mm/yy
dd/mm/yy / dd/mm/yy
dd/mm/yy / dd/mm/yy
dd/mm/yy / dd/mm/yy
dd/mm/yy / dd/mm/yy
dd/mm/yy / dd/mm/yy

PROJECT TITLE