Institutional Review Board Proposal Form essay

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The most obvious benefit is that participants will approach the use of technology more thoughtfully in their practice -- and potentially change some of their technology-dependent behaviors and resistance to technology.

b. Describe what new information may be learned from this research

The study is designed to explore the barriers and incentives related to the use of technology in the social work practice.

c. Describe incentives to encourage individuals to participate in this research (including monetary or other compensation, thank you gifts, course or other academic credit, lotteries, etc.)

Participants will be sent a thank you gift in the form of a Starbucks gift card.

d. Describe costs (time, monetary or other) for participants in this research

The only expenditure of resources for participants is time.

e. Describe potential harms or discomforts (physical, psychological, social) for participants in this research

No potential harms have been identified for participants in this study, and all responses are to be kept confidential.

f. Describe what you will do to minimize potential harms or discomforts to participants in this research


g. Describe any potential harms to the culture or society that is the subject of this research

No potential harm to the culture or society has been identified.

h. Describe what you will do to minimize potential harms to the culture or society that is the subject of this research


10. Participant Consent / Assent

Unless a waiver is requested and granted, all participants should be fully informed about the research (purpose, benefits and potential harms from participation, procedures, duration of participation, and special accommodations for language or comprehension), informed consent shall be documented by a written and signed consent form and the participant shall be given a copy of the signed form. The recommended reading level for consent documents is the 8th grade. Guidelines and examples for consent/assent forms can be found at .



Describe the process of obtaining consent to participate in this researchNote: The IRB will only consider this if you can demonstrate that obtaining informed consent will impact the quality of the research data; a waiver will not be granted for researcher convenience.

If the participants are minors, describe the process of obtaining assent to participate in this research


Describe how you will communicate to potential participants that their participation is voluntary and that they may withdraw from the research at any time without penaltyNote: Project documents and assent forms for children must be at an age appropriate level. Documents for general population adults should not exceed an 8th grade reading level. If you are having problems achieving that level, contact the Office of Research Integrity ( -- or x7800) for assistance.

Participants will be informed that they can terminate their participation in the study at any time during the course of the study.

Describe if there was any deception involved in the generation of archival data, or if there is any deception involved in the consent process prior to data collection

N/a No deception occurs in this study.

Place an "X" in the first column if you requesting special accommodations to consent for this research.

Request for Special Consent Procedures


a. Elements of informed consent are presented orally and documented through a short written consent form; the process shall be documented by a witness



b. Electronic acknowledgement of informed consent (e.g., SurveyMonkey)

< he study is conducted online and consent will be obtained through electronic means in the form of an official consent form, and then again just before responding to the survey questions.

c. Waiver of the requirement for documentation (written, audio or video) of informed consent Note: The IRB will only consider this if you can demonstrate that obtaining informed consent will impact the quality of the research data; a waiver will not be granted for researcher convenience.


d. Waiver of some or all of the elements of consent Note: The IRB will only consider this in instances where it would culturally inappropriate or if the documentation is the only way to link the participant to the project and disclosure of their involvement may result in harm.


e. Approval of reading level greater than 8th grade in consent documents Note: Project documents and assent forms for children must be at an age appropriate level. Documents for general population adults should not exceed an 8th grade reading level. If you are having problems achieving that level, contact the Office of Research Integrity ( -- or x7800) for assistance.


f. Approval for inclusion of participants whose primary language is not EnglishNote: The IRB regularly approves this request, but you must provide an explanation of the translation services that will be provided This may include providing the IRB with both English and non-English versions of consent, assent and other project documents.


g. Approval for inclusion of adults with diminished cognitive capacityNote: You will need to determine whether or not these individuals are able to give informed consent. If not, you will have to obtain consent from a legal guardian in addition to the individual's assent.


11. Data Storage and Retention

Required Information


a. Describe how the data will be collected or recorded (e.g., paper instruments, electronic records, field notes, audio/video recordings, notes, etc.)

Study participants will complete an online survey that they can access once they have agreed to participate and have signed the consent form.

b. Describe who will have access to the data

Only the researcher and the research assistants will have access to the data.

c. Describe how you will maintain confidentiality of the data

Data will only be held in electronic form and be accessible by password. Participants and their responses are identified by number, and no identifiable information will be retained in data, whether in aggregate or disaggregate form.

d. Do you have a federal Certificate of Confidentiality for this research?

No. N/a

e. Describe your plans for retention of data, where it will be stored, how long it will be stored, who will be responsible for maintaining and securing it, how it will be destroyed and when it will be destroyed

Data will be stored in electronic files in a secure cloud in which the researcher and the research analysts can achieve ready access. The data will be stored indefinitely in aggregate form. Disaggregate, individual data responses will be retained for two years following the presentation of the findings at conferences. After the designated time period, the data will be erased by the researcher.

f. Describe your plans for using the data you collect (e.g., published in journal or equivalent, non- published written report, presented at conference or equivalent, archive only)

The study findings will be reported at state and national conferences. Manuscripts of the study will be submitted to juried periodicals.

g. Describe your plans for sharing the data and results with the community or population from whom the data were collected

Study participants will have a complete copy of aggregate data in the format submitted to the professional journals.

h. Describe how you will transfer, communicate and share data among research team members, including description of encryption or security protocols

Because a survey software will be used to collect and analyze the data, the researcher does not anticipate a need for data transfer. The data in the survey software is automatically encrypted, such that, making printed copies of disaggregated data is not possible.

i. Describe where and how consent documents will be stored
12. Special Participants and Data Considerations: Place an "X" in the first column to indicate which of the following groups you are specifically seeking to include as participants in this research.


In the table below, explain how your research proposal is responsive to the NSF Principles for the Conduct of Research in the Arctic (if applicable -- see


If your research project involves the use of restricted private health information, please view IPAA information at and explain in the table below how your proposal is responsive to these requirements.


If your research has the potential to uncover actual or suspected cases of abuse or neglect of children or vulnerable adults, please consult the appropriate Alaska statute (47.17…[continue]

Cite This Essay:

"Institutional Review Board Proposal Form" (2012, February 22) Retrieved December 4, 2016, from

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