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Procedures for Completing the

Research Project Notification and Human Subjects Protection Form

As outlined in UMUC policy 130.25, Conducting Research Involving Human Subjects, all UMUC students, staff, faculty, and individuals external to UMUC, who wish to conduct research involving human subjects must adhere to this policy before conducting any research.

All researchers must complete the Research Project Notification and Human Subjects Protection Form before initiating any research. Please fill in each blank and provide copies of any additional documents (i.e. draft questionnaires) as necessary.

1. If you are a UMUC student who wishes to conduct research in fulfillment of course requirements, you will need to complete the Research Project Notification and Human Subjects Protection Form and turn it into your course instructor.

1. If your research is limited to the students in your course and your course instructor determines that there is minimal risk, the course instructor may approve the research.
2. If the research includes individuals external to UMUC or your course instructor determines that the research involves more than minimal risk, the instructor will forward the research form to the unit's IRB representative. The IRB representatives may decide on behalf of the IRB, or may forward the form for a full review.
3. If the research involves additional UMUC students, staff or faculty outside the immediate classroom or the instructor determines that there is more than minimal risk, the form must be first forwarded to the Director of Institutional Accountability, Planning, and Research for approval, then to the unit's IRB representative. The Director of Institutional Accountability, Planning, and Research is located in Room 3120, 3501 University Boulevard East, Adelphi, Maryland 20783. The IRB representative may decide on behalf of the IRB, or may forward the form for a full review.

You will need all appropriate signatures before any research may be initiated. Your course instructor will ensure that the offices listed in paragraph VI. of Policy 130.25 are notified.

1. If you are UMUC student who wishes to conduct research not in fulfillment of course requirements, you must complete the Research Project Notification and Human Subjects Protection Form and turn it into your unit's IRB representative.

1. If the research involves individuals external to UMUC and your IRB representative determines that the research involves only minimal risk, the IRB representative may decide to approve the research on behalf of the IRB. If the proposal involves more than minimal risk, the proposal will be brought to the IRB for a full review.
2. If the research involves UMUC students, staff or faculty, the form must be first be forwarded to the Director of Institutional Accountability, Planning, and Research for approval, then to the unit's IRB representative. The Director of Institutional Accountability, Planning, and Research is located in Room 3120, 3501 University Boulevard East, Adelphi, Maryland 20783. The IRB representative then will review the proposal to determine the risk to the human subjects. If the IRB representative determines that there is less than minimal risk, the IRB representative may approve the proposed research activity. If the proposal involves more than minimal risk, the proposal will be brought to the IRB for a full review.

You will need all appropriate signatures before any research may be initiated. Your IRB representative will ensure that the offices listed in paragraph VI. of Policy 130.25 are notified.

1. If you are UMUC faculty or staff who wishes to conduct research involving individuals external to UMUC, you must receive signed approval from both your unit's senior vice president and your appropriate IRB representative (described in UMUC Policy 130.25) on your completed Research Project Notification and Human Subjects Protection Form before conducting any research. Your IRB representative will ensure that the offices listed in paragraph VI. of Policy 130.25 are notified.
2. If you are UMUC faculty or staff who wishes to conduct research involving UMUC students, faculty, and/or staff, you must receive signed approval from both the Director of Institutional Accountability, Planning, and Research and your appropriate IRB representative (described in UMUC policy 130.25) on your completed Research Project Notification and Human Subjects Protection Form before conducting any research. The Director of Institutional Accountability, Planning, and Research is located in Room 3120, 3501 University Boulevard East, Adelphi, Maryland 20783. Submit your completed form first to the Director of Institutional Accountability, Planning, and Research, then, if approved, to your appropriate IRB representative. Your IRB representative will ensure that the offices listed in paragraph VI. of Policy 130.25 are notified.
3. If you are an individual external to UMUC who wishes to conduct research involving UMUC students, faculty, and/or staff, you must receive signed approval from both the Director of Institutional Accountability, Planning, and Research and your appropriate IRB representative (described in UMUC policy 130.25) on your completed Research Project Notification and Human Subjects Protection Form before conducting any research. The Director of Institutional Accountability, Planning, and Research is located in Room 3120, 3501 University Boulevard East, Adelphi, Maryland 20783. Submit your completed form first to the Director of Institutional Accountability, Planning, and Research, then, if approved, to your appropriate IRB representative. Your IRB representative will ensure that the offices listed in paragraph VI. of Policy 130.25 are notified.

If you have any questions about the form, ask your IRB representative.

Research Project Notification and Human Subjects Protection Form

Date: __________________________

 

Name of Proposer:__________________________

Email: __________________________ Phone: __________________________

Fax: __________________________

 

Unit Representative: __________________________

Email: __________________________ Phone: __________________________

Fax: __________________________

 

1. Title of Project: ___________________________________________________________

2. Purpose of the Project:

 

 

 

 

 

3. Survey Instruments or Data Collection Methodology to be used.

A. Interview, focus group, questionnaire, or other? __________________________

If other, please explain.

 

 

B. Online, regular mail, face-to-face, or other [survey]? __________________________

If other, please explain.

 

 

C. Please attach a copy of each instrument if it has been prepared. If not, explain how it will be developed.

 

 

 

4. Research Design including population and sample, if applicable.

A. UMUC Students, Staff, Faculty, or other? __________________________

If other, please explain.

 

 

Continued…

B. Sample Size_____

C. What information will be collected (e.g. any potentially sensitive subjects such as drug use, etc) ?

 

 

 

 

D. What data other than the respondents' answers will be sought (e.g. via access to UMUC records)?

 

 

 

E. How will the privacy and confidentiality of the human subjects be recorded and stored?

 

 

F. How will the analysis protect the respondent's right to privacy (e.g., if less than five people are in a table cell, how will their identity remain anonymous)?

 

 

 

5. Signature Approvals

______I have read and understand the UMUC Policy 130.25 and, the procedures for completing the Research Project Notification and Human Subjects Protection Form. I have completed the Research Project Notification and Human Subjects Protection Form fully and accurately. I agree to comply with UMUC Policy 130.25.

 

________________________________ _______________

Research Proposer Date

 

______I have determined that the proposed research involves minimal risk and is limited to individuals within the proposer's course and is approved.

______I have determined that there may be a risk to human subjects and will forward the application form to the appropriate unit IRB representative.

 

________________________________ _______________

Course Instructor Date

Continued…

______I have determined that the proposed research will not denigrate the integrity of UMUC data collection nor will it put an undue burden on the Office of Institutional Accountability, Planning, and Research.

 

________________________________ _______________

Director of Institutional Accountability, Planning, and Research Date

 

______I have determined that the proposed research involves minimal risk and is approved.

______I have determined that the proposed research involves more than minimal risk and/or is being completed by an individual external to UMUC and must be forwarded to the IRB to complete a full review.

 

________________________________ _______________

IRB Representative Date

 

 

The IRB has completed a full review. The proposed research has been:

___________ approved.

___________ disapproved.

Explanation:

 

 

 

 

________________________________ _______________

IRB Chairperson Date