External Research Application Form

External Research Application Form
Centre for Evaluation and Research (CER)
Department of Health and Human Services

Contents

Background information

Strategic Plan Priority actions

Instructions to applicants

About assessment

External research application

Application details

Criterion 1: Alignment to one or more of the strategic plan priority actions

Criterion 2: The benefits gained from the activity

Criterion 3: The extent of resourcing required to support the activity

Criterion 4: The risks associated with supporting the activity

Criterion 5: In-house support and coordination of client, staff and data access

Criterion 6: Dissemination strategy

Criterion 7: Overview of research protocol

External Research Application Form1

Background information

The Centre for Evaluation and Research (CER) welcomes research requests that improve data and evidence to enable delivery of the Department of Health and Human Servicesstrategic plan and related outcomes.

Strategic Plan Priority actions

•Victorians are healthy and well

•Victorians are safe and secure

•Victorians have the capabilities to participate

•Victorians are connected to culture and community

To read the full plan and to identify the outcomes relevant to your research, see Our strategy on the DHHS website <

Instructions to applicants

This application form must be completed by researchers or research teams wishing to obtain approval from the department to undertake a research, evaluation, analysis, forecasting or modelling activity that involves Human Services staff, clients or access to data.

This process is not applicable to activities the department has funded, contracted or will undertake through a collaborative agreement with relevant parties.

This process is separate to human research ethics approval. Information about the department’s human research ethics approval is available on Health.vic’sDepartment of Health and Human Services Human Research Ethics Committee page Students are requested to obtain ethics approval from their own University and submit this approval to the Centre for Evaluation and Research with their External Research Application. A copy of the University ethics approval must be submitted when a project is approved by the CER before commencing the research activities with departmental clients, data or staff.

About assessment

Applications are assessed based on the following criteria:

  1. alignment to one or more of the Strategic plan priority actions and the associated Outcomes framework
  2. benefits gained from the research activity to the department’s clients, communities, service systems or wider public
  3. extent of resourcing (staff, facilitation, data access) required and available to support the activity
  4. risks associated with supporting the activity
  5. duplication of effort, coordination with similar or complimentary activities
  6. dissemination strategy to provide evidence publications, reports and tools to department staff and stakeholders
  7. assessment is not based on thequality of the research, evaluation, analysis, forecasting or modelling method, however applicants are asked to provide details about the method for monitoring and co-ordination purposes.

External research application

Application details

Application title

Title

Application type

Application type / Mark with X
Academic
Multi-centre
Local government
State government
Commercial
Community
Other – specify:

Contact details

Please list the details of the chief and associate investigators for the project. Add boxes if needed.

Students are eligible to apply and should be listed as the chief investigator. The supervisor of any student projects should be listed as the associate investigator.

Chief Investigator
Item / Response
Title
First name
Last name
Qualifications
Department
Organisation
Postal address
Work phone
Mobile phone
Email
Fax
Associate Investigator
Item / Response
Title
First name
Last name
Qualifications
Department
Organisation
Postal address
Work phone
Mobile phone
Email
Fax

Criterion 1: Alignment to one or more of the strategic plan priority actions

Applicants are encouraged to read the full plan, available at Our strategy on the DHHS website <

Which priority action does this application relate to?

Priority action / Mark with X
Victorians are healthy and well
Victorians are safe and secure
Victorians have the capabilities to participate
Victorians are connected to culture and community
Unsure – I need guidance to identify the relevant action.
None – Please do not continue to complete this form. The department does not have capacity to support initiatives that do not align with the DHHS priority actions.

Addressing the priority action

Outline how the application directly addresses one of the department’s priority actions (about 100 words or less).

How the application directly addresses one of the department’s priority actions

Adding to existing knowledge and research

Outline how this application adds to existing knowledge and research in this area (about 100 words or less).

How the application adds to existing knowledge and research in this area

Criterion 2: The benefits gained from the activity

Application benefits

Please outline how this application will benefit:

•the department

•staff

•policy, programs or service delivery, or

•the clients of the department to build better lives and achieve their potential.

Benefit / Mark with x / Description
Potential benefit to the department’s clients, communities, service systems or wider public
Potential benefit to the department and government (such as policy)
Potential benefit to the researchers (such as partnerships, publication)
Potential benefit to the fields relevant to Health and Human Services (theory, knowledge or practice)
Other benefits
The research does not have primarily commercial or material benefits
Note:The department does not generally provide approval for research which is undertaken primarily for commercial or material gain. / [Describe – for example, the research outputs, services or intellectual property are not expected to generate commercial returns via income and/or capital gains]

Criterion 3: The extent of resourcing required to support the activity

Areas to be involved in supporting this application

Please identify relevant areas for involvement at the department. Visit the Our organisation page on the DHHS website < to review how the department is structured to deliver services and provide regulatory oversight.

Relevant area / Mark with X
Children and Families Reform Unit
Children, Families, Disability and Operations
Corporate Services
Health and Wellbeing
Housing, Infrastructure, Sport and Recreation
Organisational Redesign
Regulation, Health Protection and Emergency Management
Strategy and Planning
Family Safety Victoria
Safer Care Victoria
Victorian Agency for Health Information
None, this project will not require support from departmental staff or funded programs to complete.
Unsure, I need guidance to identify the most relevant areas

Project duration

How long will the project take including data collection, finalising the report and products, and publication?

Duration / Mark with X
1 to 3 months
4 to 7 months
8 to 12 months
12 to 18 months
18 to 24 months
3 years
4 years
5 years

Cost and funding arrangements

Please outline the cost and funding arrangements for the project.

Cost / Funding arrangements
$

Assistance required

Please outline the assistance required by the department to support the application

Intangible costs (in-kind support)
Details / Amount / Office use only
$
Staff time
Assistance / Mark with X / Number of staff / Office use only
Interviews
Focus groups
Surveys
Interpreting data
Facilitating access and communications to clients
Providing project, policy, service information
Access to data
Details / Mark with X / Description
Describe and specify aggregate or individual / Office use only
Administrative / Aggregate (de-identified) or Individual (identifiable)
Description:
Client details / Aggregate (de-identified) or Individual (identifiable)
Description:
Staff details / Aggregate (de-identified) or Individual (identifiable)
Description:
Service, policy, project details / Aggregate (de-identified) or Individual (identifiable)
Description:
Access to clients
Assistance / Mark with X / Number of clients / Office use only
Interviews
Focus groups
Surveys
Access to services
Assistance / Description / Number of sites / Office use only
Site visits
Other
Assistance / Description / Number or cost / Office use only
Other

Criterion 4: The risks associated with supporting the activity

Risks to clients, staff or service delivery activities

Please identify any risks that the application may pose for the department’s clients, staff or service delivery activities.

Risks

Access to identifiable or potentially identifiable information

Access to identifiable information / Mark with X
Not required
Required

If accessing identifying or potentially identifiable information, please explain why this is necessary?

If access is required, explain why

Approvals from other organisations

Approval from other organisations / Mark with X
Not required(if possible please provide evidence of exemption, such as letter from Human Research Ethics Committee)
Required
Organisation details

Provide details of any approval required by other organisations. Mark approval status with X.

Name of organisation / Approval granted / Approval pending / Application yet to be submitted

Criterion 5: In-house support and coordination of client, staff and data access

DHHS contacts

Please confirm who you have spoken with in the department about this application.

Add additional contact tables as needed. Please do not provide contact details for people you have not had direct phone or email contact with.

DHHS contact 1
Item / Response
Title
First name
Last name
Position
Area
Work phone
Mobile phone
Email
DHHS contact 2
Item / Response
Title
First name
Last name
Position
Area
Work phone
Mobile phone
Email

Project links to other departmental research or evaluation projects

To your knowledge please identify how the project links with any other research or evaluation projects planned or currently being delivered in the department?

Approval from other organisations / Mark with X
None:the researcher is not aware of any links with other research or evaluation projects
Unsure: I need guidance to identify other links with research or evaluation projects

Criterion 6: Dissemination strategy

Sharing findings

How will the findings of the project be shared with department staff and clients?

Publications and resources
Publication type / Mark with X
Framework for use
Tool for use
Journal article
Training
Report
Summary report
Joint publication
Thesis
Conference or seminar paper
Workshop, presentation or seminar
Presentation type / Mark with X
Participant evidence presentation and discussion
Evidence application roundtable
Other methods
Other – please detail

Working with policy and program staff

Please describe how the research team will work with policy and program staff to ensure that research is relevant and applicable to human services delivery?

How the research team will work with policy and program staff

Criterion 7: Overview of research protocol

Applications are not assessed based on theresearch, evaluation, analysis, forecasting or modelling method. Applicants are required to provide details about the background and method for monitoring and co-ordination purposes.

Background rationale

Please outline the background and rationale for the project? Include references as footnotes.

Background rationale for project

Purpose, aims and objectives

Please outline the purpose, aims and objectives of the project

Purpose, aims and objectives of the project

Research questions

Please outline the research questions

Research questions

Proposed method

Please detail the proposed method for the research.Please use sub-headings

Research design

[Describe]

Sample or participants

[Describe, including start and end dates for data required]

Data collection tools

[Describe]

Procedures

[Describe steps involved]

Data analysis

[Describe]

Ethical considerations

[Describe]

To receive this publication in an accessible format phone 9096 0904, using the National Relay Service (13 36 77) if required, oremail the Centre for Evaluation and >.

Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne.

© State of Victoria, Department of Health and Human Services, December 2017.

Available on the Evaluation and research support intranet page

External Research Application Form1