IRB Expedited & Full Review Form

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The function of the IRB is to protect the safety, welfare, rights, and privacy of all participants in human subjects research that proceeds under the guidance of faculty, staff, and students on our campus. The purpose of the Illinois Wesleyan University IRB is to assure that all human subject research conform to Federal regulations. Our Policy and Procedures derive from the ethical principles issued by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in 1979.

Are you submitting this proposal for an expedited or a full review? *

Expedited Review

Full Review

Research Title: *

Principal Investigator (PI) or Faculty Supervisor:

Provide the following information for the principal investigator (PI) or the faculty supervisor of the proposed research. For student research or research conducted by individuals outside the IWU community, an IWU faculty or staff member must be listed as primary investigator. Students and other individuals are considered co-Investigators/researchers. PIs or faculty supervisors will correspond directly with IRB - no IRB application from students or external agents will be accepted.

Name *

(first last)

Email *

enter the full email address: example - "_____@iwu.edu"

University Affiliation *

Faculty

Staff

Other

Co-Investigators:

Are there any co-investigators? Enter their information here (name, university status). You are responsible for sharing all IRB communication with your co-investigators.

Research Project

All materials, questionnaires, interviews, surveys, tests, and/or equipment to be used in this project must be included in your attachments at the end of this form.

Describe the proposed research, including research objective(s) or research question(s) and the significance of the research. *

What will participants be asked to do? Explain in a step by step process. *

Where will the research take place? How long will participants be involved in this research? Include the number of sessions and the duration of each session. *

Project Timeline: *

Expected ending date of the research

Data Collection & Analysis

Indicate the nature of the data to be collected. *

individual identities can never be tied to the data they provide (anonymous)

individual identities can be tied to their data but this information is secured by the researcher (confidential)

other (e.g., research is neither anonymous nor confidential, or different methods are used for different stages)

Describe procedures for data collection and analysis, including how participants’ identities are handled. Where will the data be stored and how will its security be guaranteed? Who will have access to the data and to what extent? How and when will the data be destroyed? *

This includes raw survey data, transcripts of interviews, coded data, survey data stored online, etc.

If the research involves recording participants, address the following: What type of recordings will be made (audio, video, photograph)? Where will the recordings be stored and how will the security of the recordings be guaranteed? Who will have access to the recordings and to what extent? How will the recordings be transcribed and coded, if at all, and by whom? How and when will the recordings be destroyed? *

Participants & Recruitment

Will you intentionally recruit participants from any of the following populations? *

(Check all that apply)

people with developmental disabilities

people with physical disabilities

people with psychiatric disabilities

minors (under 18 years old)

pregnant women

institutionalized persons

inpatients/outpatients

citizens of other countries

members of a specific ethnic/cultural group

None of the above populations will be intentionally recruited

Required

Will you intentionally recruit PI's or co-investigator's students, friends, classmates, staff, clients, patients, etc.? *

Yes

If you are intentionally recruiting members any of the above, describe that population here AND describe additional safeguards included in the research to protect rights/welfare of participants/groups. *

Outline recruitment procedure below, including any criteria for exclusion. *

You must include as attachment/link below a copy of any recruiting materials (e.g., advertisement, invitation letter, invitation email, poster, etc), if applicable.

Describe any compensation that will be offered to participants for their participation in this research? *

(monetary, extra credit, etc.)

Informed Consent/Assent:

Include a copy of all consent and assent forms to this application. IRB will not start its review process until all forms are submitted.

Will signed consent (and assent from minors, when applicable) be obtained (electronically or in writing)? If not, explain the rationale for not collecting consent/assent. *

Signed assent from minors and informed consent from guardians/parents is generally expected in the case of research involving minors.

By submitting this form, I assure IWU IRB that the following statements are true:

-The information provided in this form is correct.
-I will seek and obtain prior written approval from the IRB for any substantive modifications in the proposal or to the proposed study.
-I will promptly report any unexpected or otherwise significant adverse events or unanticipated problems or incidents that may occur in the course of this study.
-I will not begin my research until I have received an IRB approval.
-I will maintain records of this research according to IRB guidelines.
-I understand that approval of this research could be suspended or terminated, if these conditions are not met.

Reviews of proposals commence only if an application is complete.

It is the principal investigator’s responsibility to provide IRB with the complete application along with all necessary documents (i.e. survey questions, interview questions, etc.). Use the following fields to provide links to the relevant documents (these documents should be linked from a file sharing platform, such as Google Drive or DropBox). If all the following exist in a single document, paste the link in each field.

Consent form *