Global Research and Clinical/Community Engagement (GRACE) Grant Application

PLEASE NOTE THAT APPLICATIONS MUST BE SUBMITTED AT LEAST 12 WEEKS (3 MONTHS) AHEAD OF THE PLANNED DATE OF DEPARTURE. ANY APPLICATOIN SUBMITTED WITHIN 12 WEEKS OF DEPARTURE WILL NOT BE REVIEWED. ONCE RECEIVED, YOUR APPLICATION WILL BE REVIEWED AND A RESPONSE WILL BE PROVIDED WITHIN 2 WEEKS. IF CHANGES TO THIS APPLICATION ARE REQUIRED, THEY MUST BE COMPLETED AND THE APPLICATION RESUBMITTED WITHIN 2 WEEKS. THANK YOU.

Project Title

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Type of Project

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☐ Clinical Observership ☐ Language Training ☐ Service Learning ☐ Research

Executive Summary/Abstract

Please provide a brief summary of your proposal. This should include an introduction to the country and context where you propose to work, your goals and objectives, proposed activities,and other relevant information. Word limit: 200-300 words.

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General Information

  1. Name of Student (Leader if part of team):

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  1. Names of Team Members (if applicable):

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Mentor Information

Note:Every project should have a UTHSC or UTSPH faculty mentor. If the HSC/SPH mentor will not be at the international site during project activities, a non-HSC mentor must also be identified and provide a signed Invitation Letter.

  1. HSC Faculty Mentor

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Note: please attach the following items for your HSC faculty mentor to your application:

☐Curriculum Vitae

☐Signed Support Letter

  1. Non-HSC Mentor

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Note: please attach the following items for your non-HSC mentor to your application:

☐Curriculum Vitae

☐Signed Support Letter

Site Information

  1. This is a:

Note: please select only one option.

☐New Site & HSC Project/Program

☐Previously Approved Site, but a new HSC Project/Program

☐Previously Approved Site and continuation of existing HSC Project/Program

  1. Country
  1. City/Town
  1. Organization/Institution
  1. Site Context

Please describe the organization/institution and site you propose to work with. This should include a description of the available resources and logistical capacity of the organization/institution (human resources, transportation & accommodation, administrative support, translators, communications, etc.), past and current programs/projects, number of international students that visit annually, and the historical role of students at site. Finally, how was the need for your activity/project identified?

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  1. Language

Note: List your proficiency in the language of country/region in which the project will take place. If applicable, describe plans for translation and communication.

Note:If participating in a language immersion program, YOU MUSTdescribe how you will prepare before leaving for site (including online and in-class language courses).

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Project Description

  1. Project Objectives (SMART)

Describe at least 2 measurable objectives your proposed project will address. Your project’s objectives should be written in SMART format, which means they are Specific, Measurable, Attainable, Relevant, and Time-Bound. Please review the following document to learn how to write SMART Objectives:

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  1. Project Timeline

Proposed Dates of Elective (total time to spend at site)

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Estimated Time to Completion of ALL Project Activities (Note: this includes any activities upon return to US,such as data analysis, reporting, program design, etc.)

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  1. Beneficiaries

Please give an estimate of the specific type(s) and number of beneficiaries of your program/activity. If doing a clinical rotation, please provide the best estimate for the number of patients you will see/engage with over the elective period. Examples: 500 women, 120 patients presenting at emergency room, 1,000 households, and 25 nurses & physicians.

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  1. Literature Review

Provide background on the country and site that you will be traveling to, including relevant health and development indicators. This includes a description of the burden of disease (using indicators for life expectancy, infant & child mortality, maternal mortality, major causes of morbidity and mortality, etc.), population demographics, the health care system, political system and economy. If completing a clinical elective, please describe the specific patient population, common conditions/illnesses and any other relevant information. If conducting research or a service learning project, describe relevant research and program activities from the literature and how it has been determined that there is a need for this program/project/research. Your literature review should include a minimum of four (4) references and all sources must be cited using AMA citation styles. (500 words maximum)

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  1. Methods/Activities

Note: If you are conducting research, please answer Part A; if a service learning (which includes language immersion) project, please answer Part B; if completing a clinical elective, please answer Part C. If you are engaging in more than one, please answer all relevant sections.

  1. Research: please provide the full details of your research methods. This should be the same information outlinedin your IRB protocol, including: study design; study population, sampling methodology and projected sample size; a description of your data collection tools; data management and analysis procedures; and your research timeline. (500 words maximum)
  2. Service learning/Language Immersion project: please describe, in detail, the activities and tasks that you will complete, along with a timeline for when each activity will be performed and completed. (500 words maximum)
  3. Clinical elective: please describe, in detail, your clinical responsibilities and any other tasks that you have agreed upon with your site mentor. (500 words maximum)
  1. Deliverables

Please describe ALL of the deliverables for this project. All projects are required to provide at least one deliverable: a research paper OR poster presented at a professional conference (including the annual CMHE CSL conference or UTMB Global Health Symposium). Project partners and mentors might have additional deliverables, which should also be listed here. (200 words maximum)

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  1. Reflection

Please describe the mechanism you will use for reflection (i.e. journaling, blogging, discussions with mentor), and the manner in which your Project Mentor will engage with you in the reflection process. (200 words maximum)

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  1. Learning Objectives and Career/Educational Goals:

What skills, knowledge and experience do you expect to gain as a result of this project? How does the project relate to your career goals? (200 words maximum)

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  1. References

List the references/work cited. Remember to use AMA citation styles.

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  1. Budget

Note: Be very clear about describing how much the project/experience is going to cost. Line items must include travel expenses, project costs, source(s) of additional funding, etc as outlined in the budget template. Please include any in-kind contributions. If any items are unusual or unclear, please provide an explanation in the notes section. Please use the GRACE Application Budget Template.