Use of State-approved IRBProtocol
Statewide IRB approval has been obtained for evaluation forms for these VolunteerIN training materials. Collecting data from the individuals who participate in this series will guide the development of future training materials. Please follow the steps below to obtain permission to collect data from these evaluation forms.
1.Log onto the CES Intranet Web site using your career account (beginning with onepurdue\).
2.Click on “Program Development, Evaluation & Human Subjects.”
3.Click on “Human Subjects.”
4.Click on “Forms for Reporting.”
5.Click on and read “Procedure To Use An Already Approved Protocol.”
6.Click on “Letter For Already Used Protocols,” open or save the file in a Word document format, then make appropriate changes – OR – Complete the top part of the sample letter found on the next page, print it on your office letterhead, sign it, and send it to the Principal Investigator (PI).
7.The PI will complete the bottom of the letter, sign it, and send it back to the Educator.
8.Fax or mail a copy of both the request and permission letter to Cathy Burwell, CES Administration, 615 West State Street, West Lafayette, 47907; 765-494-5876.
9.Read and follow the approved protocol when distributing and collecting the evaluation forms. (See below for specific procedures to be followed.)
10.Return completed evaluation forms to the PI by the date indicated on the approval letter.
Thank you for your willingness to help with the evaluation of the VolunteerIN training materials!
Specific procedures to be followed for VolunteerIN
The Extension Specialist will administer the following procedures for the “Essential Elements of 4-H Youth Development Evaluation” during the first program in the VolunteerIN series that will be broadcast statewide via two-way videoconferencing. He will read the instructions at the top of the Evaluation form so that all participants will know the purpose of the evaluation (to plan future programs) and the location where they may turn in their completed forms (in an envelope in the back of the room). No information will be shared from any single evaluation form, nor will information be tied to any person’s name. Participants will not include their name or any other identifying characteristics on the evaluation form. Delegates will leave their evaluation form in an envelope at the back of the room as they leave the session. The Extension Specialist will instruct the on-site facilitators to pick up the evaluation forms left by the participants and return them to campus in a sealed envelope. He will then compile the information to be used when planning future programs and to prepare an Impact Statement on the effectiveness of the VolunteerIN adult volunteer training series.
The “VolunteerIN Lesson Plan Evaluation” form will be used for all subsequent lessons that will be led by Purdue University Extension Educators. The Educators will ask the volunteers to complete the evaluations at the end of the program, have the volunteers place them in an envelope, then mail them to the Specialist on campus for data entry.
(PRINT ON DEPARTMENT OR COUNTY LETTERHEAD)
Steve McKinley, Principal Investigator (PI)
Department of Youth Development and Agricultural Education
615 West State Street, AGAD 226
West Lafayette, IN, 47907-2053
Dear Steve,
I am requesting permission to use your protocol and data collection forms from VolunteerIN adult volunteer training series in association with ______(name of project or program to be offered). I agree to follow the approved protocol procedures exactly as written and will not alter nor change any data collection instrument.
In addition, I agree to report back to you annually on my use of this protocol no less than 30 days prior to a specified date. This report will include: (1) the number of people participating in the protocol in the past year (or since last reporting date); and (2) any “adverse events” or unanticipated event associated with using your protocol. However, I will notify you immediately in the case of a serious adverse event or other serious unanticipated event or if the protocol has not been followed exactly as it is written.
(If applicable, insert the following paragraph and complete the following section on funding support information circling the appropriate phrase).
I will be seeking or have sought external funds to support this activity.
External Funding Agency or Sponsor: ______
Funded Project Period:______
Grant PI: ______
If you are agreeable to my using your protocol, please complete the information below, sign and keep a copy for your human subjects research protocol file. Return the original to me so I may send a copy of this form to the Director of Extension Office. The EHSAC Coordinator will distribute copies to the Purdue IRB and the Office of Research Administration as needed.
Sincerely,
Signature of Extension Educator Requesting Permission
Title and County
Dear (insert Educator’s Name),
You have my permission to use my protocol, VolunteerIN adult volunteer training series, IRB reference number #0611004709. The protocol and all associated materials are in theVolunteerIN, 4-H Toolkit for Success materials. The protocol has a study end date of December 31, 2007(when determined Exempt by Purdue IRB).
Please report to me on your use of this protocol no less than 30 days prior to December 1. I will notify you if there are any revisions to this protocol. In addition, I will notify you if this protocol is no longer active at which time it may no longer be used.
Sincerely,
Steve McKinley, PI
Extension Specialist,
Leadership/Volunteerism