IRB Application for Community-Based Participatory Research

1. Project Information

Project Title Principal Investigator(s) Affiliation(s) Contact Email

2. Community Partner(s)

Organization(s) / Group(s) Main Contact Person Role/Contribution of Community Partner(s)

3. Project Description

Research Purpose & Objectives Background & Significance Community Involvement in Study Design

4. Methods

Research Methods / Data Collection Research Site(s) Estimated Timeline

5. Participants

Participant Inclusion/Exclusion Criteria Recruitment Process Estimated Sample Size

6. Risk and Benefits

Potential Risks to Participants Potential Benefits to Participants/Community Risk Minimization Strategies

7. Informed Consent

Consent Process (Who, How, When) How will participants’ confidentiality be protected?

8. Data Management & Dissemination

Data Storage, Security, and Access Data Sharing Plan How will results be shared with the community?

9. Additional Comments or Information