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American Samoa Community Cancer Network _ASCCN_

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American Samoa Community Cancer Network _ASCCN_ Powered By Docstoc
					American
Samoa
Community
Cancer
Network
(ASCCN)
Community Cancer
Research Application
2008-09

amsamccn@gmail.com
                                                                                      ASCCN Community Cancer Research Application 2008-09




                                                                                                                                                                    2




Table of Contents
Introduction .................................................................................................................................................. 3
Eligibility Requirements ................................................................................................................................ 4
Application Process & Project Process.......................................................................................................... 5
Levels of Community Participation ............................................................................................................... 6
Request to Conduct Research through the ASCCN ....................................................................................... 7
Community Research Application Pack ...................................................................................................... 11
Research Project Budget Guidelines ........................................................................................................... 11
Application Part 1 - Concept ....................................................................................................................... 12
Application Part 2- Community Participation Statement ........................................................................... 14
Application Part 3- Timeline ....................................................................................................................... 15
Proposed Budget Form ............................................................................................................................... 16
Community Support Letters........................................................................................................................ 17
Community Research Project Presentation Guide ..................................................................................... 17
Application Scoring Sheet ........................................................................................................................... 18
Useful Websites .......................................................................................................................................... 19




                                                                                                                             amsamccn@gmail.com
                                                        ASCCN Community Cancer Research Application 2008-09




                                                                                                          3

Introduction
Thank you for your interest in community-based cancer research in American Samoa. And
congratulations for completing the American Samoa Community Cancer Network’s 2008 Researcher
Training Program! We invite you to harness your interest, skills and commitment to add to the
Territory’s understanding of cancer and cancer-related topics by applying for Cancer Network funding to
conduct a community-based research project.

The American Samoa Community Cancer Network (ASCCN) aims to lessen the burden of cancer amongst
resident in the Territory—reducing incidence, morbidity and mortality. To this end, the 2008 ASCCN
Community Training Program was developed to enable community members and students to design and
carry out culturally appropriate and effective community-based research projects focused on gathering
and interpreting first-hand data.

Your Community Cancer Research Project will allow you to apply the information and skills you gained
from the researcher training modules. Please refer to workshop materials to help you complete this
application and implement your funded project.

All research projects must focus on a specific community. The participation of your community
members in the planning, implementation, and evaluation of activities is vital and partnership with
established community groups is encouraged.

The Cancer Network is excited to partner with you throughout the project process. We feel confident
that you will gain a valuable experience contributing to the reduction of cancer health disparities in
American Samoa. The Training Program Manager, Sara Krosch, will be your primary contact for any
questions and support. Email: amsamccn@gmail.com



Our Best,



ASCCN Principal Investigator



ASCCN Assistant Director



ASCCN Training Program Manager


                                                                                 amsamccn@gmail.com
                                                       ASCCN Community Cancer Research Application 2008-09




                                                                                                         4


Eligibility Requirements
In order to receive ASCCN funding support for a community cancer research project you must meet the
following eligibility criteria:

     Be a community member, college student or high school student currently residing in American
      Samoa

     Single applicants or at least one applicant in a pair or team must have completed the 4 required
      ASCCN researcher training modules conducted August – November 2008
            Community Surveys
            Community Tools
            Planning & Evaluating Health Programs
            Social Marketing

     Propose a research project that will contribute new knowledge to one or more of the following
      health disparity areas:
           Increasing cancer screening
           Promoting cancer survivorship
           Informing tobacco use policy
           Increasing tobacco cessation
           Investigating links between cancer-risk and nutrition, physical activity and/or obesity

     Submit a research project plan with the input and approval of at least one community partner

     Conduct research methods with a specific currently residing in American Samoa

     Develop a research project plan that can feasibly be completed between January 20, 2009 and
      March 31, 2009

     Complete all parts of the enclosed research project application and submit all parts by 4:00pm
      on their due dates

     Give a short presentation on your research application to the ASCCN Steering Committee and
      other community members and field questions

     Obtain Institutional Review Board (IRB) approval of research plan, data-gathering instruments
      and English-Samoan translations before implementation

     Sign memorandums of agreement with the ASCCN pertaining to data sharing and budgetary
      disbursements




                                                                               amsamccn@gmail.com
                              ASCCN Community Cancer Research Application 2008-09




                                                                             5
2008-09 Application Process




2008-09 Project Process




                                                     amsamccn@gmail.com
                                                      ASCCN Community Cancer Research Application 2008-09




                                                                                                        6
Levels of Community Participation
All community research plans must incorporate some level of meaningful community participation.
Please refer to the diagram below when deciding which level of community involvement you will aim for
in your community research project.




                                                                              amsamccn@gmail.com
                                                                    ASCCN Community Cancer Research Application 2008-09




                                                                                                                       7
Request to Conduct Research through the ASCCN
The following form must be completed and submitted to the ASCCN no later than 4:00pm Monday
December 8, 2008 to initiate the Research Project Approval Process. All information must be typed in
the fields below. Any additional information must be attached. You may submit a hardcopy (paper) of
this form or an electronic version as an email attachment sent to amsamccn@gamil.com

Part 1 - Researcher Information (complete 1 per individual researcher)

1) Name                                                             2) Birth Date

3) Birthplace                                                       4) Citizenship




5) Education

High School                                               Graduation Date

Undergraduate School                                      Graduation Date                        Degree

Graduate School                                           Graduation Date                        Degree

Other                                                     Graduation Date                        Degree



6) Current Employer                                                 7) Job Title/Position



8) Past Research Experience (literature reviews, surveys, interviews, focus groups, laboratory, etc.)

Project/Title, Year                                       Brief Description




                                                                                                  amsamccn@gmail.com
                                                                 ASCCN Community Cancer Research Application 2008-09




                                                                                                                        8
Part 2 – Proposed Research (complete one per application)

9) Research Project Focus (choose all that apply)

    ___Increasing cancer screening

    ___Promoting cancer survivorship

    ___Informing tobacco use policy

    ___Increasing tobacco cessation

    ___Investigating link between cancer-risk and nutrition

    ___Investigating link between cancer-risk and physical activity

    ___Investigating link between cancer-risk and obesity

10) What specific health problem do you intend to investigate? (behavioral/environmental)




11) Research Context – Summary of Literature Review: (what is the health issue, who is most affected, where is it a
problem, when does the problem occur, how much does it affect the individual/community and how much does it cost, why
should this health issue be researched; 300 word limit, minimum 5 cited sources)




                                                                                              amsamccn@gmail.com
                                                             ASCCN Community Cancer Research Application 2008-09




                                                                                                                  9
Part 2 – Proposed Research continued

11) Research Context – Summary of Literature Review-continued




12) Based on your literature review, what is your main research question that will add new knowledge about this
health issue?




                                                                                        amsamccn@gmail.com
                                                                ASCCN Community Cancer Research Application 2008-09




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13) Describe your Specific Research Population (age, gender, location, other demographics):




14) Describe your Sampling Plan (what type of random or non-random sampling plan will you use?):




15) What is your proposed Sample Size?




16) What Data Collection Strategies will you use? (Choose at least 2)

___ Surveys                          ___Observations/Counts             ___Other: (describe)

___Interviews                       ___Community Tools

___Focus Groups                      ___Mapping




17) Will any materials or data-gathering instruments need English-Samoan translation?

18) How do you plan to translate materials and/or instruments?




Please submit to the ASCCN no later than 4:00pm Monday December 8, 2008.




                                                                                          amsamccn@gmail.com
                                                             ASCCN Community Cancer Research Application 2008-09




                                                                                                            11
Community Research Application Pack
The following forms must be completed and submitted to the ASCCN no later than 4:00pm Monday
December 15, 2008 to complete the Research Project Application Process:

       Completed Community Research Project Plan
                  Part 1 - Concept
                  Part 2 - Community Participation Statement
                  Part 3 - Timeline
       Budget Form
       Letter of Support signed by community partner(s) (minimum of 1)

You may submit hardcopies (paper) of these forms or an electronic version as an email attachment sent
to amsamccn@gamil.com




Research Project Budget Guidelines
ASCCN funding will support the implementation of research methods and data analysis activities. The
maximum amount to be granted for a community research project will be $3000.00 US. There is no
minimum award. All budget items must be appropriately linked to research activities and justified in the
Budget Form. Original receipts will be required of all purchases. Personnel will be paid $5.00US/hour
according to itemized bi-weekly timesheets.

The following are eligible for ASCCN funding:

       Supplies- office and other materials
       Services- Printing, Production
       Rental- Equipment, Space, etc.
       On-island Travel Expenses- gasoline reimbursement
       Personnel- not to exceed 1/3 of total budget
       Honorarium/Stipends to research informants
       Food & Refreshments related to research activities

The following are NOT eligible for ASCCN funding:

       Equipment Purchase
       Off-island Travel Expenses
       Clinical Services

Applications can be strengthened by documenting ‘in-kind’ contributions from community partners.
Please detail all in-kind donations on the Budget Form and assign a logical dollar amount to each.



                                                                                    amsamccn@gmail.com
                                                                     ASCCN Community Cancer Research Application 2008-09




                                                                                                                         12
Community Research Project Plan

Part 1 – Concept
Research Project Title


Health Problem                                               Health Disparity Area(s)



Contributing             Research Questions (Address risk factors)                      Research Methods
Risk Factors                                                                            (To answer research questions)




                                                                                                amsamccn@gmail.com
                                                                          ASCCN Community Cancer Research Application 2008-09




                                                                                                                                             13
Community Research Project Plan continued

Part 1 – Concept continued
                                           Data Gathering & Analysis Activities
Formative Activities (What steps must be completed BEFORE you carry out your research methods? With whom?)




Process Activities (How will you carry out your research methods? What data will you get from research methods? From whom? How will
you manage your data collection?)




Success Indicators (How will know you have answered the research questions thoroughly?)




Impact Activities (How will you analyze your data?)




Outcome Activities (How will your data be used lessen the health disparity area? How will you share the results of your research project?)




                                                                                                           amsamccn@gmail.com
                                                            ASCCN Community Cancer Research Application 2008-09




                                                                                                                14
Community Research Project Plan continued

Part 2 – Community Participation Statement
Research Project Title



Community Participation Statement—Explain what level of community participation you will aim to achieve
when implementing your research project. What community partners will you work with? What specific
activities will you plan to gain community participation and gather community input? What community
participation challenges do you foresee and how will you overcome them? (250 word limit; Refer to the ‘Levels
of Community Participation’ definitions provided on page 6.)




                                                                                       amsamccn@gmail.com
                                                                 ASCCN Community Cancer Research Application 2008-09




                                                                                                                           15
Community Research Project Plan continued

Part 3 - 2009 Timeline
Please list all research project activities in the order you plan to do them. Include all Formative activities, data-
gathering activities, data analysis activities, and reporting activities. Required activities have been filled in below.

Research Project Title



 Month                                                Activities
January          Obtain IRB approval of data-gathering instruments, English-Samoan translations
                 Sign data sharing agreement and budgetary disbursement agreement


February




                Attend Mid-Project Data Analysis Training

March




April




                Report final project results to community partners, research informants and ASCCN




                                                                                             amsamccn@gmail.com
                                                          ASCCN Community Cancer Research Application 2008-09




                                                                                                               16
Community Research Project Plan continued

Proposed Budget Form
Research Project Title

Budget Category          Total    Budget Justifications
                         Amount   (Link each item to specific activities in the Research Project Plan)
                                  Item            Item Description
                                  Amount
Supplies



Services



Rental



On-Island Travel



Personnel



Honorarium/Stipend



Food/Refreshments



TOTAL

In-kind Donations




Please submit to the ASCCN no later than 4:00pm Monday December 15, 2008.

                                                                                          amsamccn@gmail.com
                                                           ASCCN Community Cancer Research Application 2008-09




                                                                                                          17
Community Support Letters
Letters of Support of community partners must be completed and submitted to the ASCCN no later than
4:00pm Monday December 15, 2008 to complete the Research Project Application Process.

Researchers are required to obtain at least one (1) letter of support from a community partner you
intend on working with during the implementation of your research project.

Community partners include:

       Representatives of your research population
       Gatekeepers, such as community leaders
       Representatives of cooperating community organizations
       Representatives of cooperating agencies

Community Support Letters should clearly state that community partners understand and support the 1)
purpose of your research, 2) the proposed methods and 3) how the results will be used.




Community Research Project Presentation Guide
After submitting your Community Research Project Application Pack you are required to give a short
presentation the ASCCN Steering Committee on Wednesday December 17, 2008 at Sadie Thomson Inn
form 11:00am-1:00pm. Please invite your proposed community partners who signed letters of support.

Your presentation should be no longer than 5 minutes. Be prepared to answer questions.

Please present briefly on the following:

       Main research question
       Why this research should be conducted
       Specific research population and how you will obtain your sample
       Research methods you plan to use
       How community partners are involved




                                                                                  amsamccn@gmail.com
                                                                 ASCCN Community Cancer Research Application 2008-09




                                                                                                                 18
Application Scoring Sheet
The following sheet will be used to score your 1) Request to Conduct Research through the ASCCN, 2)
Community Research Application Pack, and 3) Oral Presentation. There is no minimum or maximum
number of applications eligible for funding. Applications receiving a total score below 50 are unlikely to
be funded. All applicants will receive copies of their scoring sheets. Applicants will be awarded 1)
unconditionally, 2) awarded conditionally pending changes or additions to applications or 3) not
awarded and asked to reapply during the next funding cycle.

                                ASCCN Community Cancer Research Application
                                           REVIEW CRITERIA

         Research Project Title:_________________________         Reviewer: __________ Date: __________

            5 = Excellent      4= Good      3= Average     2= Needs Improvement      1 = Unacceptable

                        COMPONENT                                                              SCORE

1. Proposal addresses a priority ASCCN research area                                   0   2    4   6   8   10

2. Research problem and context clearly explained                                      0   1    2   3   4   5

3. Over-all study design is scientifically sound                                       0   1    2   3   4   5

4. Research subjects are specifically identified                                       0   1    2   3   4   5

5. Choice of research methods                                                          0   1    2   3   4   5

6. Data analysis plan                                                                  0   1    2   3   4   5

7. Community partnerships secured                                                      0   1    2   3   4   5

8. Level of community participation                                                    0   1    2   3   4   5

9. Researcher expertise to complete the project                                        0   1    2   3   4   5

10. Researcher utilizing skills obtained from training program                         0   1    2   3   4   5

11. Realistic timeline for completing the project                                      0   1    2   3   4   5

12. Budget is sufficient and accurate to achieve research objectives                   0   1    2   3   4   5

13. The proposal is sensitive to community protocol                                    0   1    2   3   4   5

14. Sound plan for Samoan language translation (if applicable)                         0   1    2   3   4   5

15. Likelihood of producing data to publish/support grant applications                 0   1    2   3   4   5



                                                                                        amsamccn@gmail.com
                                                              ASCCN Community Cancer Research Application 2008-09




                                                                                                             19
Useful Websites
ASCCN Research Training Module slides and materials
www.sarakrosch.com

National Cancer Institute Fact Sheets
www.cancer.gov/cancertopics/factsheet

Mayo Clinic Fact Sheets
www.mayoclinic.com

CDC Fact Sheets
www.cdc.gov/hiv/resources/factsheets/index.htm

United Nations World Health Organization
www.who.int/en/
www.educationforhealth.net/home/defaultnew.asp

Secretariat of the Pacific Community – Public Health
www.spc.int/php/

Robert Woods Johnson Foundation (childhood obesity)
www.rwjf.org/childhoodobesity/

The Cochrane Collaboration (meta-analysis of health issues)
www.cochrane.org/

PubMed (abstracts)
www.ncbi.nlm.nih.gov/pubmed/

Asia Pacific Islander American Health Forum
www.apiahf.org/

Medline Plus Health Information
http://www.nlm.nih.gov/medlineplus/medlineplus.html

Library C.A.R.D. Health and Wellness Resource Center
www.infotrac.galegroup.com/itweb/pago99255
Enter library card #

Pacific Resources for Education and Learning (PREL) *
www.prel.org > Need to do research? > EBSCO Database and STAT!Ref
Username: amsamoa         Password: amsamoa

*only 10 logged on at any one time in Territory



                                                                                     amsamccn@gmail.com

				
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