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Centres for Health Research

2019 Metro South HHS - Research Support Scheme

PROGRAM GRANT APPLICATION FORM

Applications Close 5pm, 20 August 2018

All Research Support Grant applications are required to demonstrate enhanced cross disciplinary collaborations across Metro South HHS (e.g. across medical, allied health, nursing departments, and basic/clinical research). Research proposals must demonstrate potential for the research to be translated into improved health outcomes.

PROGRAM GRANTS support a body of research work over a 3 year period. $250,000 is offered and the budget must include people and project activities, and a research higher degree student or novice/ early career researcher as Chief Investigators (CI) along with corresponding part time salary

PART A: INSTRUCTIONS AND GENERAL ELIGIBILITY CHECK

1. APPLICATION INSTRUCTIONS

Refer to the Research Support Scheme 2019 Funding Guidelines when preparing your application https://metrosouth.health.qld.gov.au/sites/default/files/content/2019-rss-funding-guidelines.pdf

All sections of the form must be completed. The Applicant is required to sign the application on behalf of the research team.

2. SUBMISSION

Applications must be submitted electronically to [email protected]

A signed copy of the application to be submitted as a PDF (electronic signatures accepted)

The application must also be submitted in Word format (signatures not required)

Save your application file using the following naming convention: Applicant Surname_2019 Program

3. DUE DATE

Applications must be received electronically by the Centres for Health Research

Applications are due no later than 5.00pm Monday 20 August 2018

Late or incomplete applications may not be accepted

4. ENQUIRIES TO: The Centres for Health Research

Metro South Hospital and Health ServiceEmail: [email protected] Phone: 07 3443 8057

mailto:[email protected]

https://metrosouth.health.qld.gov.au/sites/default/files/content/2019-rss-funding-guidelines.pdf

5. APPLICANT ELIGIBILITY CRITERIA

To be eligible for a 2019 Research Support Grant the Applicant must be able to answer:

Yes to questions 1-6

No to question 7

Yes No

1 Are you a member of staff of MSH (Honorary Appointees are not eligible)?

2 Will your appointment be for the duration of the grant?

3 Will the majority (more than 50%) of the research activity take place on a MSH campus?

4 Does the research demonstrate cross disciplinary collaborations? Select the disciplines involved:

Medical ☐Allied Health ☐Nursing ☐Basic / Clinical Research ☐

5 Does your application provide for the engagement of a Novice or Early Career Researcher or a Postgraduate or Research Higher degree student?

6 Are all the Co-investigators

a) a member of staff of MSH with an appointment for the duration of the grant OR

b) a member of staff of a Metro South Health academic partner university school or research institute based on a Metro South Health campus

7 Is the proposed research activity currently funded through an award type currently listed on the Australian Competitive Grants Register or international equivalent?

https://www.education.gov.au/news/2018-australian-competitive-grants-register-acgr-now-available

6. APPLICANT APPOINTMENT DETAILSProvide details of your MSH and/or academic partner university appointment(s) (maximum 300 characters including spaces) E.g.: Occupational Therapist at PA Hospital; MSH provides UQ with 50% of my salary; QUT Postgraduate Candidate based at IHBI in the Translational Research InstituteNOTE: N/A (or similar) will not be accepted

7. LOCATION OF RESEARCH ACTIVITYProvide details of where the majority (more than 50%) of the research activity will take place (maximum ¼ of an A4 page)

V3.0 Effective: June 2018 Review: January 2019 of 18



PART B: GRANT APPLICATION FORM

2019 METRO SOUTH HHS - Research Support Scheme

RESEARCH PROGRAM GRANT APPLICATION

1. PROGRAM TITLE

(Maximum 200 characters including spaces)

2. INVESTIGATIVE TEAM

The Applicant must be the PI (Principal Investigator).

The maximum number of: Co-Investigators (CIs) = 4; Associate Investigators (AIs) = 2

Title Name Health profession

Organisation MSH FractionE.g.: 0.5 FTE or none

PI Click to choose

First name Surname Click to choose Click to choose

CI1 Click to choose


CI2 Click to choose


CI3 Click to choose


CI4 Click to choose


AI1 Click to choose

First name Surname Click to choose Type name here

AI2 Click to choose

First name Surname Click to choose Type name here


3. INCLUSION OF NOVICE / EARLY CAREER RESEARCH OR POSTGRADUATE OR RESEARCH HIGHER DEGREE STUDENT

The Program Grant must include a Metro South Health researcher who is a novice / early career researcher or postgraduate or research higher degree student

Please describe (in ½ an A4 page or less):

how this researcher will be incorporated and budgeted for in the Program of work

the expected benefits to the Program and this researcher

Expected outputs from this researcher

4. ASSESSMENT OF PROGRAM APPLICATIONS:

Assessment of Project Applications will be against the criterion listed below: Assessment Criteria 1: Scientific Quality

Assessment Criteria 2: Budget

Assessment Criteria 3: Clinical Significance

Assessment Criteria 4: Originality and Innovation

Assessment Criteria 5: Track Record - Relative to Opportunity

Assessment Criteria 6: Collaborative Strength & Capacity Building

4.1 ASSESSMENT CRITERIA 1: SCIENTIFIC QUALITY

4.1.1 RESEARCH PROPOSAL

Provide your research proposal on the following pages. Include Applicant’s name, Title of project, Hypothesis, Expected outcomes, Background, Research protocol and references. Ensure that you describe how you have provided funding for and incorporated a novice / early career research or postgraduate or research higher degree student on this program grant.

Assessment of the scientific quality of the research will be based on:

Definition of project (based on clear articulation of the Hypothesis, Background, Expected outcomes)

Study Design (Based on Methods, Research Protocol)

Feasibility (including assessment of Methods and Budget)

Whether the proposal would be competitive nationally


Insert your Research Proposal in the box below (You can type directly into the box; cut and paste or insert an embedded PDF. See Instructions – inserting text

INSTRUCTIONS

1. Research Proposal Format

Maximum 4 pages including references

Arial font with a minimum size of 10 point (including tables, table legends and figure legends)

Line spacing of 1.5 lines

Top and bottom page margins of 2 cm

Left and right page margins of 2 cm

2. Inserting Text

Type directly into the text box above, maintaining format as described above; or

Cut and paste (e.g. from a previous document) into the text box – note you may lose formatting if you choose this option; or

Embed a PDF document (displayed as icon) of your complete proposal, maintaining formatting as described below.

- Prepare your Research Proposal as per the format instructions above - Save your Research Proposal as a PDF document- Place Cursor in the box above- Select “Insert” tab on MSWord Toolbar- Select “Object” and choose “Create from File” from drop down- Browse for your PDF document- Select Insert- Select “Display as Icon”- Click OK- An icon of your Research Proposal content should be displayed in the box above.

4.2 ASSESSMENT CRITERIA 2: BUDGET

4.2.1 BUDGET PROPOSAL

List all items individually (hit enter in the field to add additional lines)N.B. Funds must be expended within 3 years


BUDGET CATEGORIES AMOUNT REQUESTED

Personnel

i. include type of appointment and on-costs

ii. include the facility institution where this person will undertake the majority of the research

iii. include whether this person is a MSH staff member

Total

Equipment

i. List items costing more than $500 each

ii. Indicate whether they will be procured through MSH

Total

Maintenance / Consumables

i. Include equipment items costing $500 or less each

ii. Identify whether these items will be procured through MSH

Total

Travel / Conferences

Total

Otheri. Note: Computers will not be funded

ii. May also include Biostatistics services; Clinical Research Facility Costs; Biorepository costs; Legal Costs for

Intellectual Property Considerations; Pharmacy; Pathology; X-ray costs.

Total

GRAND TOTAL

Budget justification


4.3 ASSESSMENT CRITERIA 3: CLINICAL SIGNIFICANCE Assessment of the significance of the proposed research will be on the basis of:

Burden of disease

Translation Impact

Innovation

4.3.1 BURDEN OF DISEASE

Describe how this project will address and reduce the burden of disease addressed in your proposal (maximum ½ an A4 page)

4.3.2 TRANSLATIONAL ASPECT OF THE RESEARCH PROPOSALWhat is the translational aspect of your project? (Select one box)

T0 – Identification of opportunities and approaches to a health problem (basic research)

T1 – Findings from basic research tested for clinical effect and/or applicability (Phase I and II clinical trials; observational studies)

T2 – Health application to evidence based practice guidelines (Phase III clinical trials; observational studies; evidence synthesis and guidelines development)

T3 – Practice guidelines to health practices (dissemination research; implementation research; diffusion research; Phase IV clinical trials)

T4 – Practice to population health (outcomes research; population monitoring of morbidity, mortality, benefits and risk studies)

Not applicable

Definitions taken from UC San Diego Clinical and Translational Research Institute

4.3.3 RESEARCH SIGNIFICANCEWhy is this research clinically significant ? (Maximum of ½ an A4 page)

4.4 ASSESSMENT CRITERIA 4: CLINICAL ORIGINALITY AND INNOVATION

Describe how your proposal is clinically original and / or innovative (Maximum of ½ an A4 page)


4.5 ASSESSMENT CRITERIA 5: TRACK RECORD - RELATIVE TO OPPORTUNITY

4.5.1 PRINCIPAL INVESTIGATOR (PI) (APPLICANT)

PI CONTACT DETAILS

Applicant name Click to choose First Name Surname

Position

Organisational department Department name

Phone number(s) Primary: Secondary:

Email address

P1 ACADEMIC QUALIFICATIONS & APPOINTMENTS

Academic QualificationsE.g.: MBBS:

Academic AppointmentsE.g.: Senior Lecturer, XXDept., UQ :

PI RESEARCH TIME

Expected 2019 time allocation to: This study (hr/wk): Other studies (hr/wk):

Do you expect to have an extended period of absence during 2019? Yes No

If Yes, provide expected dates DD/MM/YEAR - DD/MM/YEAR

Reason(¼ A4 page or less)

PI PUBLICATIONS

List your publications produced in the last 5 years which have the most relevance to the study proposed in this application with ALL authors provided) Press <Enter> after each publication to maintain the numbering system

1.

PI GRANTS


Provide details of research funding received in the last 5 years and indicate whether the funding relates to the proposed research of this application. If more than 8 please eliminate least applicable to this research proposal.

Funding body and type Start dateEnd date

Amount Relevant to this application?

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

[DD/MM/YYYY]

[DD/MM/YYYY]

$ Yes

No

PI RESEARCH PERFORMANCE RELEVANT TO OPPORTUNITY

Are there any disruptions to your career (greater than 28 calendar days) that may have impacted on your research performance that you would like to have taken into consideration?

Please outline in the section below in less than ¼ of an A4 page

1.


4.6 ASSESSMENT CRITERIA 6: COLLABORATIVE STRENGTH & CAPACITY BUILDING

4.6.1 CO-INVESTIGATOR 1 (CI1)

CI1 CONTACT DETAILS

CI1 name Click to choose First Name Surname

Position

MSH site Click to choose


Phone number

Email address

CI1 ACADEMIC QUALIFICATIONS & APPOINTMENTS


Academic AppointmentsE.g.: Senior Lecturer, XX Dept., UQ :

CI1 RESEARCH TIME


Does CI1 expect to have an extended period of absence during 2019? Yes No



CI1 PUBLICATIONS

List publications produced in the last 5 years which have the most relevance to the study proposed in this application with ALL authors provided

Press <Enter> after each publication to maintain the numbering system

1.



CI2 CONTACT DETAILS


Position



Phone number

Email address

CI2 ACADEMIC QUALIFICATIONS & APPOINTMENTS



CI2 RESEARCH TIME





CI2 PUBLICATIONS



1.



CI3 CONTACT DETAILS


Position



Phone number

Email address

CI3 ACADEMIC APPOINTMENTS



CI3 RESEARCH TIME





CI3 PUBLICATIONS



1.



CI4 CONTACT DETAILS


Position



Phone number

Email address

CI4 ACADEMIC APPOINTMENTS



CI4 RESEARCH TIME




Reason(1/4 A4 page or less)

CI4 PUBLICATIONS



1.

4.6.5 ASSOCIATE INVESTIGATOR 1Outline the role of AI1 in the broad research plan proposed in this application and indicate why AI1 has been included within the research team (maximum ½ an A4 page)


4.6.6 ASSOCIATE INVESTIGATOR 2

Outline the role of AI2 in the broad research plan proposed in this application and indicate why AI2 has been included within the research team (maximum ½ an A4 page)

4.7 OTHER SUBMITTED GRANT APPLICATIONS

Provide details of grant applications related to this study submitted to other funding bodies in the current year

Funding body and type Project title Budget

$

$

$

$

$

$

4.8 NOMINATIONS OF EXPERTS

Applicants must nominated three experts who may be called upon to provide expert opinion on your grant application (they will not be the sole reviewers as in previous years)

For nominations to be eligible the Applicant must be able to answer Yes to all questions

Yes No

1 Are all three nominated experts external to MSH and the university school(s)/research institute(s) of all named investigators?

2 Is at least one nominated expert from interstate or overseas?

3 Are all three nominated experts acknowledged experts in the field of the proposed research (i.e. publication track record, PhD or equivalent research experience)?

4 Are all three nominated experts completely independent of the investigative team (including AIs) and without conflict of interest? (See section 7.4.1 of the 2019 Funding Guidelines)

5 Have all three nominated experts agreed to be available from September to October to provide expert advice to the MSH Review Panel? Please ensure you advise the expert of the name of the PI on this grant as all correspondence with the experts will be linked to the PI name

Note: A breach of the above may disadvantage your application


4.8.1 EXTERNAL EXPERT 1

Name Click to choose First Name Surname

Health profession Click to choose

Organisation/Institution Organisation/Institution name

Department Department name

Phone number: Email:

Availability confirmed? Yes No

Comments (¼ A4 page or less)

Who contacted this expert?




















4.8.4 EXCLUDED EXPERTS

If relevant, list details of up to two experts you would like excluded from providing expert opinion on your application and provide justification for their exclusion

EXCLUDED EXPERT 1





Justification Provide details

EXCLUDED EXPERT 2





Justification Provide details


5 AGREEMENTS AND CERTIFICATION OF SUPPORT

CERTIFICATION BY THE PRINCIPAL INVESTIGATOR

Please carefully read each of the criteria and ensure the application complies. Marking each box indicates your certification of each criterion. Incomplete applications may be deemed ineligible.

I certify that:

Written agreement (such as an email) has been obtained from all investigators named in this Research Support application and that all details provided are correct.

I understand that should this application be successful, all named Co-Investigators on this application will be required to sign the Acceptance of Offer.

On behalf of the investigative team, we accept and agree to comply with the ethical standards as set out by the National Health and Medical Research Council, and any additional standards required by the appropriate Human Research/Animal Ethics Committee (including, but not limited to the National Statement on Ethical Conduct in Human Research and Australian Code for the Responsible Conduct of Research).

Research will not commence until all ethical clearances and site specific approvals (SSAs), if required, have been obtained.

I acknowledge and accept that grant payments from SERTA can only be made to a Metro South Health (MSH) employee, and must be deposited into a MSH research cost centre.

The research team meets the relevant eligibility criteria for the Metro South Health Research Support Scheme and all mandatory questions have been answered.

Progress reports (Ethics and Projects) must be provided annually and / or a final report must be provided at the end of the support period

On behalf of the investigative team, we accept and agree to comply with Metro South Health. Policies and Procedures and requests from the Centres for Health Research – Metro South Health in the management of these grants.

Name of Principal Investigator (print): SignatureDigital signatures will be accepted

DD/MM/YEAR

Date:


6 CERTIFICATION BY HEAD OF DIVISION/DEPARTMENT

I certify that:

The proposed research is appropriate to the general facilities in my Division/Department and that I am prepared to have the project carried out in my Division/Department.

Experiments involving humans/animals (will) conform to the general principles set out in the National Health and Medical Research Committee’s National Statement on Ethical Conduct in Human Research/Australian Code of Practice for the Care and Use of Animals for Scientific Purposes

Name of Head of Department (print):

SignatureDigital signatures will be accepted

DD/MM/YEAR

Date:

Name of MSH site/university/school:

Note: If the Head of Department is also the Principal Investigator then he / she cannot provide certification.


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