Join dementia research - Non-Portfolio Study Application Form

Join Dementia Research is an easy-to-use service which allows people to register their interest in dementia research, so they can be contacted about relevant research studies. Further information on how the system works can be found on the 'Researchers' page of the Join Dementia Research website.

This application form should be used by researchers wishing to recruit volunteers to dementia research studies which are not on the NIHR Portfolio.

NOTE: the system enables researchers to identify and contact potential volunteers. To use the system, you will need to be issued with a user account, undergo a one-hour training programme and your institution will need to approve your use through a Data Processing Agreement. This will be managed as part of your application, which can take 6-8 weeks.

If your study is on the NIHR Portfolio, please email jdr.support@nihr.ac.uk to discuss adding your study to Join Dementia Research.

If your study is not on the NIHR Portfolio, please complete the application form below, and a member of the delivery team will be in contact shortly.
Sign in to Google to save your progress. Learn more
Your name: *
Organisation name: *
Address: *
Telephone number: *
Email: *
Website:
Do you have an NHS employment contract? *
If yes, who is your NHS contract with?
Do you already have a Join Dementia Research Researcher account? *
Your study name: *
Name, Title and organisation of the Chief Investigator or Principle Investigator of the study 
REC / Ethics number for your study:
Who gave ethics approval? *
Research funder: *
Number of volunteers required from Join Dementia Research: *
Is your research study part of a PhD or Masters degree?
Clear selection
Geographical scope: *
(Give description and example e.g. by region and / or distance from site)
Planned opening date on Join Dementia Research:
MM
/
DD
/
YYYY
Planned closing date on Join Dementia Research:
MM
/
DD
/
YYYY
Please provide a brief lay summary of your study answering the following questions:*
The plain English summary of your research study needs to have enough information to help someone, including those with dementia, or their carers, decide if your study is suitable for them. Many people with dementia will find reading and understanding written information difficult.

You should be mindful of people's experience and remain respectful. Please avoid using research terminology or language that may be upsetting for the reader living with or supporting a person with the condition.
Background to the research (In Layperson terms)
  • Why is this research being done - give 1 or 2 sentences as a background to why your research is important in the field
  • Aim(s) of the research - 2 to 4 sentences maximum 
  • What are you aiming to find out - sets the scene. Please also mention here if there has been any Patient Public Involvement in the design of the study
What does the study involve? (in layperson terms)
  • What taking part in the study will involve for the volunteer - what tests will be done? how is the study drug administered? what is the intervention? will it involve a one to one interview?
  • Where will the study visit take place - can the study be completed from home? Are there any visits to a hospital or clinical site?
  • How many visits there are
  • How long the study will run/how long the volunteer will be involved in the study
Participants - Who you are looking for (in layperson terms)
  • What eligibility criteria do the volunteers need to meet - Person with dementia, carers, volunteers without dementia etc. If the volunteers require a diagnosis of dementia, please state which type of dementia and whether symptoms need to be whether mild, moderate or severe
  • Age range 
  • Exclusion criteria - pre-existing medical conditions, medications, pacemaker fitted etc.
Patient and public involvement and dissemination (in layperson terms)
Briefly describe how the patients and the public have been involved in developing the research. Briefly describe how the findings of the research will be communicated and used (e.g. to influence practice).
Can you or are you willing to recruit people who live in care homes as part of your research study? *
All studies using Join Dementia Research need to have appropriate ethical approval. If your study already has ethical approval but you did not previously mention Join Dementia Research in your application, you will need to make a minor amendment. Please download the Join Dementia Research non-substantial file note template to complete and attach to your master file:
If you have not yet applied for ethical approval, please insert the following text into your application:
The following is a standard paragraph that chief investigators and study teams can use and insert into A27 of their IRAS REC form.
 
REC WORDING:
 
We will also be using Join Dementia Research (JDR) as a recruitment tool. This is an online self-registration service that enables volunteers with memory problems or dementia, carers of those with memory problems or dementia and healthy volunteers to register their interest in taking part in research.
 
The purpose of JDR is to allow such volunteers to be identified by researchers as potentially eligible for their studies.  Researchers can then contact volunteers, in line with the volunteers' preferred method of contact, to further discuss potential inclusion.
 
JDR is funded by Department of Health and Social Care working in partnership with the charities Alzheimer Scotland, Alzheimer’s Research UK and Alzheimer’s Society and is Health Research Authority (HRA) endorsed. 

The online service and all associated documentation, methods of contacting volunteers and handling of data, were reviewed by a specially convened HRA committee which included experts in research ethics, data protection and information governance. Formal endorsement was issued by the HRA in a letter dated 5 November 2019.
Further information on preparing studies for Join Dementia Research can be found on the 'Researchers' page of the Join Dementia Research website.
Thank you. You are now ready to submit your application.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of National Institute for Health and Care Research.

Does this form look suspicious? Report

Google Forms