Research Collaborator Review Process
Thank you for taking the time to provide us more information about your proposed research.
We enjoy working collaboratively with investigators to generate insights that can improve the care and treatment of asthma and COPD. We view our research collaborations as partnerships, in which we work together to design, implement, and answer important questions about asthma and COPD. We have instituted a review process for potential collaborators that allows us to learn more about your work and research plans to determine if they are a good fit with our research agenda and our current capacity. Please answer the following brief questionnaire and we will be in touch soon to discuss next steps. Gathering this basic information upfront enables a more informed conversation and a faster review process.
Be sure to leave adequate time for our review process before a grant submission deadline (usually ~ 4 weeks). We appreciate your patience. Thanks!
* Required
Name
*
Your answer
Institution or Organization
*
Your answer
Link to your website
Your answer
Email
*
Your answer
Country
*
eg: USA, CA
Your answer
Are you primarily interested in asthma or COPD?
*
Asthma
COPD
Both
Other:
Describe your research questions and objectives.
*
Please copy and paste an executive summary of the proposal. (including specific aims)
Your answer
If different from your home institution/organization, where would you propose to run your study?
*
eg, name of health system and location
Your answer
Do you already have a relationship with this institution/organization?
yes
no
Other:
Clear selection
Have you received funding for this project?
*
Yes, we have received funding.
No, but we are applying now to a specific funding opportunity.
No, but we are looking out for opportunities.
No, but we are seeking funding from Propeller.
Other:
What grant(s) or other sources of funding are you targeting for this study?
*
List all that you are considering.
Your answer
When is the grant application submission deadline?
*
Your answer
Will there be multiple arms in the study design?
*
Yes, a control and intervention arm
Yes, multiple arms
No, just 1 arm
Not sure yet
Other:
What is the estimated size of the study?
*
Sample size per study arm
Your answer
How will patients be identified and recruited into the study?
*
Your answer
How long do you wish to monitor the population?
*
Your answer
Please characterize your study population
*
Check all that may apply
Children
Adults
Primarily high risk, poorly controlled
Primarily low risk, well controlled
Vulnerable populations
Medicare
Other:
Required
Will there be clinical supervision of this study population?
*
Yes, participants will be monitored by a clinical team.
Some clinical supervision.
Participants will not receive clinical supervision.
Not sure yet
Other:
Do you intend to use Propeller as an intervention or as a tool for objective data collection?
*
The intervention includes patient and provider access to the data, education and coaching through the mobile app and website
Intervention
Data collection
Both
Other:
Do you anticipate most or all of your participants will use smartphones with the sensors?
*
Yes
No
Unsure
Is it important to your study to have geotagged inhaler use data?
*
Inhaler use data associated with GPS location
Yes, it's critical.
It add an extra dimension, but is not critical.
No, it's not relevant to our study.
In which outcome metrics are you most interested?
*
Check all that apply.
Rescue medication use
Controller medication use and adherence
Control (eg, for asthma the ACT)
COPD assessment test (eg, CAT)
Healthcare utilization: ED visits, hospitalizations, outpatient visits
Cost of care
Pharmacy fills/costs
Quality of Life
Asthma Medication Ratio
Patient satisfaction
Provider satisfaction
Missed days of school/work
Lung function, eg. FEV1
Other:
Required
What are your primary endpoints and how will they be measured?
*
Your answer
What are your secondary endpoints and how will they be measured?
*
Your answer
When do you plan to start data collection?
*
Your answer
Do you plan to publish the results of this study?
*
Publication is a primary goal.
Publication is not the primary end goal, but we would consider it.
We are not considering publication.
Do you attend any of the following Conferences?
*
American Thoracic Society (ATS)
American Academy of Allergy, Asthma, and Immunology (AAAAI)
American Public Health Association (APHA)
CHEST
European Respiratory Society (ERS)
American Association for Respiratory Care (AARC)
Other:
Required
Please provide any links to any relevant journal articles, abstracts, publications, or CVs
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Propeller Health.
Report Abuse
Forms
