NEW YORK PHYSICAL THERAPY ASSOCIATION

Arthur J. Nelson Research DesignatedFund

Applications are currently being accepted for the Arthur J. Nelson Research DesignatedFund.

Instructions:

This document provides detailed instructions to complete the application. All applicants are requiredto follow these instructions and use the provided templates when submitting anapplication.

When complete you will be required to send a single email to . The subjectline should read “RDF Application_(yourname)”.

The email should contain (5) attachments. All documents should be completed on theprovided template forms and saved as individual PDF documents before submittingto

NYPTA. The 5 attachmentsinclude:

1.Biographical Information Form with all required signatures (template providedonline)

2.Tax Liability Form (template providedonline)

3.Research Plan (template provided online)

4.Curriculum Vitae for each investigator (or NIH formatted Biosketch) (single pdfdocument)

**Each CV or biosketch must be limited to 3pages**

5.Protection of Human Subjects/Animals documents (review board approval anddocumentation of training) (single pdfdocument)

You will receive a message from NYPTA confirming receipt of your application. If you donot receive a confirmation within 24 hours, please contact the NYPTA office. There will beno exceptions to the posted deadline. The Research Committee will only review applications thatare complete and follow the research planformat.

Reporting:

If awarded, the principal investigator agrees to provide a Progress Report to theChapter () at 6 months, and upon completion of the project at 12 months. If the projectis not completed within12 months, the PI must request, in writing, an extension of the project orreturn the unusedfunds.

Additionally, if awarded, the principle investigator agrees to present a platform presentation atthe annual NYPTA conference following the end of the funding cycle and provide an abstract of the workto be published in the conferenceproceedings.

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Research Plan Format: Applications should include the following components in the ResearchPlan. The Research Committee strongly urges the principle investigator to seek peer review of theapplication prior tosubmission.

1.Title Page: The following items should be included on the titlepage.

a.Principal investigatorname

b.Title of theproject

c.Proposed startdate

d.Proposed completiondate

e.Total amount of fundingrequested

2.Abstract: A brief description of the project (not to exceed 250words).

3.Specific Aims: Concisely state the objectives and hypotheses of theproject.

4.Background: Review the relevant literature pertaining to the proposed project. Clearly identifyhow the proposed study will advance what is currently known about the topic. If appropriate, makeit clear how the current project fits into any existing or ongoing studies being conducted bythe applicant (not to exceed 1 page).

5.Significance: Describe the theoretical and clinical rationale for the proposed project andits significance to physical therapy practice, research, or education (not to exceed 1page).

6.Methodology: Include the following components in this section (not to exceed 2pages).

a.Venue: where the research will takeplace

b.Subjects: selection criteria, sample size, method of recruitment, procedures forassignment togroups

c.Instrumentation: specific measurement tools, examination tests and measures,and outcome measures that will beused

d.Procedures: briefly describe the protocols and procedures that will beused

e.Data Analysis: describe the data reduction and planned statisticalanalyses

7.Use of the Data Collected: Please indicate how the pilot data collected will contribute tothe development of a larger grant application. Indicate the agency to which you will be applying,the targeted deadline, and the approximate amount of the fundingrequest.

8.Clinical Research Agenda: Identify the item(s) in the APTA Clinical Research Agenda thatthe proposal addresses.

9.Timeline for Completion: including, at minimum, the followingdates

a.Start date (release of funds will be no earlier than July1st 2017)

b.Completion date (not to exceed one year from the startdate)

c.Period of datacollection

d.Period of data analysis

e.Presentation ofresults

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10.Budget: Provide a detailed budget and the justification for the items and amountsrequested. Please consider all costs associated with the proposed project to ensuresuccess.

a.Detailedbudget:

i.Equipment (generally non-consumable)

ii.Supplies (generallyconsumable)

iii.Contractual Services (i.e. expert consultation, mailing, copying)

iv.Salary Support (indicating % time allocated to the outlinedresearch)

v.Conference Expenses (conference registration, travel, etc. for training orto disseminateresearch)

vi.Miscellaneous (i.e. subject honorarium, animalcosts)

vii.Total AmountRequested

NOTE: As a not-for profit association the NYPTA does not allow indirects to be budgeted into the RDF award. Salary and fringe may be included along with equipment, supplies, patient compensation, etc but no indirects for the institution on any of these line items. This is consistent with the national Foundation for Physical Therapy awards and other foundations with similar missions.

b.Budget justification: Provide a justification for each line item in the budget. Indicatethe institutional resources and any personnel that are available to the investigator for use inthis project. If this proposal is co-funded from other sources, including internal support, indicatethe expenditures of each funding source and how the RDF Award will contribute to theproposed project.

c.Tax Liability: If the principle investigator accepts tax liability for the funds (Tax LiabilityForm), he or she may include the appropriate taxes on the award as a line item in thebudget.

11. References: Provide citations for references included in theproposal.

Protection of Human Subjects/Animals: Please include the following documentation (singlepdf document):

1.Human Subjects:

a.Approval from the Institutional Review Board for the Protection of Human Subjects. If approvalfrom you institutional review board is pending, indicate when approval can beexpected.

b.Principal investigator certificate of completion of Human Participant Protections Education. Ifyou have not completed training otherwise, training modules are availableat

2.Animal:

a.Approval from the Institutional Animal Care and UsCommittee

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