IRB Research Application

IRB (Institutional Review Board) is charged with the responsibility of reviewing, prior to its initiation, all research (whether funded or not) involving human participants. The IRB is concerned with protecting the welfare, rights, and privacy of human subjects. The IRB has the authority to approve, disapprove, monitor, and require modifications in all research activities that fall within its jurisdiction as specified by both the federal regulations and institutional policy. 

This form reflects the first step in gaining institutional approval from North Hennepin Community College and must be completed in its entirety and contain all necessary attachments.

Indicates required field
Project/Contact Information

If research is being conducted by an outside party, provide details for the NHCC contact/responsible party.

NHCC Faculty?

Are you a member of NHCC Faculty?

Name of an NHCC faculty member who will be your on-campus liaison.

Project Dates

(Maximum of 12 months, after which a renewal request can be submitted). Please remember that you may NOT begin data collection without NHCC IRB approval.

Institutional Oversight Checklist
Other Internal Review?

Is this research subject to review by another internal committee at NHCC?

Other Location/Organization?

Is this research being conducted at another location or with a cooperative organization (e.g. schools, clinics, community agencies)?

Continuation/Extension?

Is this a continuation or extension of a project previously approved by NHCC’s IRB?

Submitted to other IRB?

Have you submitted this project to any other IRBs?

Funding

Please identify all external funding sources and provide copies of grant applications/approvals.

Project Summary

Include enough background information to understand your rationale and hypotheses at a basic level.

Research Category

Please identify research category for this project (check all that apply)

Describe the methods you propose to use in this research, including the frequency and duration of procedures, tests, and experiments. Attach a copy of all surveys, instruments, interview questions, tests, experiments, or other activities you intend to use. These must be in the final form as you intend to use them.
Recruitment Process
Access Entire Student Body?

Does your research require email access to the entire student population?

Explain briefly what procedures will be implemented to recruit students' participation.

Participant Population
Age Range of Subjects

Describe how you will identify or recruit participants. Include a description of any incentives for participation (e.g. extra credit, money, gift cards, etc.). Attach copies of any advertisements, recruitment materials, such as emails, posters, URLs, etc.)

Approach Potential Participants

Who will approach potential participants to take part in the proposed project? (check all that apply)

Participant Identification

Will participants be identified from records of some kind?
Identified by Private Records?

Are the records used private medical or student records? 
Confidentiality of Data
Direct Identifiers?

Will you record any direct identifiers (names, student identification numbers, social security numbers, addresses, telephone numbers, etc.) along with the data? 

Link Between Code and Identifiers?

Will you retain a link between study code numbers and direct identifiers after data collection is complete? 

Links/Identifiers Outside of Team?

Will you provide identifiers or links to anyone outside of the research team?

Having answered "yes" to one or more of the preceding questions, please explain why this is necessary and how you will ensure the confidentiality of your participants.

Describe where, how long, and in what format you intend to keep the data (e.g. paper, digital, electronic media, video, audio, etc.).

Data Security
Locked boxes, cabinets, offices, Etc.

What you will do to ensure the security of the data? Check all that apply

Risks & Benefits
Risks or Harm to Participants

Does this research involves any of the following possible risks or harms to participants? Check all that apply:
If yes, attach copies of your debriefing procedures.

Having answered yes to one or more of the previous questions, please describe the nature and extent of risk or harms identified. How will you minimize risks or harms to protect participants’ welfare?

Describe how this research might benefit society and how these benefits outweigh the risks identified.

Conflict of Interest
Financial Compensation?

Have/will you or a member of your immediate family receive, from the sponsor of the research, financial or other forms of compensation? 

Vested Interest?

Do/will you or a member of your immediate family have a vested interest in the company/agency/firm that is to sponsor the research? 

Include a statement on your consent form identifying potential conflicts of interest OR state why you believe such a statement if not necessary for the protection of participants.

Describe the relationship between you or a member of your immediate family and the sponsor of the research.

Reminders

If you need to upload any further documentation for your application, reminders will appear below.

Documentation Upload
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