Research Proposal Snapshot
1)The purpose of this snapshot is for external researchers to provide a summary of their proposed research to HBHC’s Research Committee. Based on the information provided here, the Research Committee will determine if HBHC will move forward as a research partner for this study. Please note that the completion of this Research Proposal Snapshot does not guarantee that HBHC will participate in the proposed research study. Any other relevant study materials should be attached.
Researcher Name:Researcher Affiliation:
Prior HBHC PI: Yes No
If yes, please detail:
Study Details
Research Study Title:
Please provide a brief summary of the project and the research aims:
What is the target population of interest?:
Funding
What is the funding source?:
What is the total Funding Amount (if available):
Projected HBHC Funding/Subcontract Amount:
Materials
If this is for a grant submission, what materials do you need from HBHC?:
What is the due date for grant submission materials?:
Recruitment
What is the target population of interest?:
How many total patients will be recruited for the study?:
How many patients will be recruited from HBHC?:
How will patients be recruited?:
Resources
Does this study support the hiring of New HBHC Staff or Buying out of HBHC Staff Time?: Yes No
If yes, please detail:
Does this study propose to have outside individuals work in HBHC space and use HBHC resources?: Yes No
If yes, please detail:
Study Data
Would HBHC share ownership of the study data and results?:
Would HBHC administration be able to see study data prior to publication?:
Authorship and Publications
Would any HBHC staff have the opportunity to serve as authors on publications?:
If not, why?:
Would HBHC be acknowledged in publications?:
Other Comments:
2.In the following table, please describe how HBHC and HBHC patients will be involved with and impacted by the proposed research study:
Involvement / ImpactHBHC / Examples: recruitment, assistance with data collection. / Examples: clinic work flow, staff training, time commitment, improved health of patient population.
HBHC Patients / Examples: patient data, patient interviews / Examples: patient waiting time, time commitment, improved quality of care.
Self / Examples:PI, Co-I, Collaborator / Examples: relevant to my research interest, fits with my career goals.
3. The Research Committee includes some individuals who are not employeesof HBHC. Since there may be some issues with confidentiality or conflicts of interest, you are being given an opportunity to indicate which individuals you are comfortable with being involved in the review of your study. Below is a list of our current members. Please check off the individuals that you are allowing to review your study proposal.
Please note that your review will not be impacted if you ask that some members not be involved in the review of your study.
Name & Title / Affiliation / YesDavid Munar, HBHC President and CEO / HBHC /
Magda Houlberg, MD, HBHC CMO / HBHC /
John Styker, NP, HBHC Provider / HBHC /
Kenyetta Drummond, HBHC Clinical Research Manager / HBHC /
Diane Burrell, Manager of Research Compliance / HBHC /
Daniel Pohl, HBHC Director of HIV/STI Prevention / HBHC /
Cathy Creticos, MD – Infectious Disease Specialist, Researcher / HBHC, Illinois Masonic, NorthShore /
Beau Gratzer –Researcher / HBHC, Lurie’s Children’s Hospital /
Lisa Kuhns, PhD – Research Assistant Professor and Associate Director of the Center for Gender, Sexuality and HIV Prevention / Lurie’s Childrens Hospital /
Phoenix Matthews, PhD - Associate Professor and Clinical Psychologist / University of Illinois at Chicago (UIC) /