Please select which pilot you are applying for.
●Community-Engaged Research Pilot Project Award: a total of $25,000 is available for one or two award(s). The applications must detail an existing or forming community-academic partnership and how the partnership will use the funds to improve community health. The intent of this award is the generation of preliminary data for feasibility and acceptability trials.
●Community-Engaged Capacity Development Award: a total of $15,000 is available for three small awards at $5,000 each. The purpose is to provide project development seed funding for investigators working to (1) develop or engage community partnerships for project design or planning purposes or (2) engage Practice Based Research Networks (PBRN) to identify local priorities and begin project planning. The proposal needs to explicitly lay out how funds will be used to build community capacity and contribute to the development of the project and how planning will take place with your community partner(s). Research is NOT required as part of the capacity development award.
Community-Engaged Research Pilot Project Award
Community-Engaged Capacity Development Award
Project Title:
* must provide value
(note: IRB/IACUC approval titles need to match the project title)
PI Name:
* must provide value
Degree(s)
Example: Ph.D., MD, MBBS, DO, Master's, Other
* must provide value
Academic rank:
* must provide value
Assistant Professor
Associate Professor
Professor
Other
Are you an early stage/new investigator? (For NIH definition of early stage investigator,
click here )
* must provide value
Yes
No
Are you a clinician?
* must provide value
Yes
No
PI Email
* must provide value
Institutional affiliation:
* must provide value
Other
* must provide value
College or Department:
* must provide value
How did you hear about the RFA?
* must provide value
Other
* must provide value
Have you previously submitted a pilot grant application to the Great Plains IDeA-CTR?
* must provide value
Yes
No
Have you ever received an award from the Great Plains IDeA-CTR?
* must provide value
Yes
No
Previous awardees applying for a second grant must indicate how their first award has benefitted clinical and translational research (e.g., significant findings, publications, new funding awards/grant submissions, presentations, etc.). Please also note if the previous award is related to the current proposal and how they are related, if at all.
* must provide value
Do you want to add a Co-PI?
Yes
No
Co-PI Institutional Affiliation:
Boys Town National Research Hospital
University of Nebraska at Omaha
University of Nebraska Kearney
University of Nebraska Lincoln
University of Nebraska Medical Center
Creighton University
Children's Hospital and Medical Center
Omaha VA Medical Center
Other
Co-PI College or Department:
Do you want to add another Co-PI?
Yes
No
Co-PI Institutional Affiliation:
Boys Town National Research Hospital
University of Nebraska at Omaha
University of Nebraska Kearney
University of Nebraska Lincoln
University of Nebraska Medical Center
Creighton University
Children's Hospital and Medical Center
Omaha VA Medical Center
Other
Co-PI College or Department:
Do you want to add another Co-PI?
Yes
No
Co-PI Institutional Affiliation:
Boys Town National Research Hospital
University of Nebraska at Omaha
University of Nebraska Kearney
University of Nebraska Lincoln
University of Nebraska Medical Center
Creighton University
Children's Hospital and Medical Center
Omaha VA Medical Center
Other
Co-PI College or Department:
Do you want to add Co-Investigators?
* must provide value
Yes
No
Name:
* must provide value
Email
* must provide value
Institutional affiliation:
* must provide value
Boys Town National Research Hospital
University of Nebraska at Omaha
University of Nebraska Kearney
University of Nebraska Lincoln
University of Nebraska Medical Center
Creighton University
Children's Hospital and Medical Center
Omaha VA Medical Center
Other
Other
* must provide value
College or Department:
* must provide value
Do you want to add more Co-Investigators?
* must provide value
Yes
No
Name:
* must provide value
Email
* must provide value
Institutional affiliation:
* must provide value
Boys Town National Research Hospital
University of Nebraska at Omaha
University of Nebraska Kearney
University of Nebraska Lincoln
University of Nebraska Medical Center
Creighton University
Children's Hospital and Medical Center
Omaha VA Medical Center
Other
Other
* must provide value
College or Department:
* must provide value
Do you want to add more Co-Investigators?
* must provide value
Yes
No
Name:
* must provide value
Institutional affiliation:
* must provide value
Boys Town National Research Hospital
University of Nebraska at Omaha
University of Nebraska Kearney
University of Nebraska Lincoln
University of Nebraska Medical Center
Creighton University
Children's Hospital and Medical Center
Omaha VA Medical Center
Other
Other
* must provide value
College or Department:
* must provide value
Do you want to add more Co-Investigators?
Yes
No
Name:
* must provide value
Email:
* must provide value
Institutional affiliation:
* must provide value
Boys Town National Research Hospital
University of Nebraska at Omaha
University of Nebraska Kearney
University of Nebraska Lincoln
University of Nebraska Medical Center
Creighton University
Children's Hospital and Medical Center
Omaha VA Medical Center
Other
Other
* must provide value
College or Department:
* must provide value
Do you want to add more Co-Investigators?
Yes
No
Institutional Affiliation:
Boys Town National Research Hospital
University of Nebraska at Omaha
University of Nebraska Kearney
University of Nebraska Lincoln
University of Nebraska Medical Center
Creighton University
Children's Hospital and Medical Center
Omaha VA Medical Center
Other
Do you want to add more Co-Investigators?
Yes
No
Institutional Affiliation:
Boys Town National Research Hospital
University of Nebraska at Omaha
University of Nebraska Kearney
University of Nebraska Lincoln
University of Nebraska Medical Center
Creighton University
Children's Hospital and Medical Center
Omaha VA Medical Center
Other
Does this research require IRB approval:
* must provide value
IRB approval not required (if your project is human subjects related but exempt from IRB review, an exemption letter or email from the IRB is still required )
Yes
Yes, application pending
IRB is prepared but not submitted
Other
To reduce potential funding delays, protocols should be submitted to the IRB for approval within 15 days of notification of award, with final approval sent to our office within 60 days. If IRB approval is not needed for
human research studies an exemption letter or email is still required.
Submission date, if applicable
Today M-D-Y
Approval date, if applicable
Today M-D-Y
Other
* must provide value
Is this a clinical study? Answer the 4 questions below to determine if your project meets the NIH definition of human subjects research and meets the new NIH definition of a clinical trial. If the answer to all four questions is "Yes", then your project is a clinical trial. For more information click
here .
Does the study involve human participants?
Is the study designed to evaluate the effect of the intervention on the participants?
Are the participants prospectively assigned to an intervention?
Is the effect being evaluated as a health-related biomedical or behavioral outcome?
* must provide value
This is a clinical study
This is not a clinical study
Does this research require IACUC approval:
* must provide value
IACUC approval not required
Yes
Yes, application pending
Other
IACUC number, if applicable
Other
* must provide value
Is this a cancer study?
* must provide value
Yes
No
If yes, do you have SRC (UNMC studies only) or institutional approval?
Yes
Pending approval
No
Other
If your study will be conducted at UNMC, please complete the "SRC New Project Form" that can be downloaded from the SRC
website . For questions regarding this process, contact the Protocol Review and Monitoring System (PRMS) office at 402-559-4232.
How do you classify your research project on the translational spectrum
* must provide value
Translational 1 - Pre-Clinical Research - Pre-clinical research connects the basic science of disease with human medicine. During this stage, scientists develop model interventions to further understand the basis of a disease or disorder and find ways to treat it. Testing is carried out using cell or animal models of disease; samples of human or animal tissues; or computer-assisted simulations of drug, device or diagnostic interactions within living systems.
Translational 2 - Clinical Research - Clinical research includes studies to better understand a disease in humans and relate this knowledge to findings in cell or animal models; testing and refinement of new technologies in people; testing of interventions for safety and effectiveness in those with or without disease; behavioral and observational studies; and, outcomes and health services research.
Translational 3 - Clinical Implementation - The clinical implementation stage of translation involves the adoption of interventions that have been demonstrated to be useful in a research environment into routine clinical care for the general population. This stage also includes implementation research to evaluate the results of clinical trials and to identify new clinical questions and gaps in care.
Translational 4 - Public Health - In this stage of translation, researchers study health outcomes at the population level to determine the effects of diseases and efforts to prevent, diagnose and treat them. Findings help guide scientists working to assess the effects of current interventions and to develop new ones.
How do you classify your research project on the community engagement continuum?
https://www.atsdr.cdc.gov/communityengagement/community-engagement-continuum.html
* must provide value
Outreach
Consult
Involve
Collaborate
Shared Leadership
Please list all project performance sites
* must provide value
Does this project involve:
New collaboration(s)
* must provide value
Yes
No
If yes, please explain
* must provide value
Work between Great Plains IDeA-CTR partnering institutions
* must provide value
Yes
No
If yes, please explain
* must provide value
Use of other INBRE/COBRE resources
* must provide value
Yes
No
If yes, what resource(s)?
* must provide value
What health priority of the Great Plains IDeA-CTR does your project address?
* must provide value
Behavioral health, defined as "emotions and behaviors that affect your overall wellbeing" (e.g., mental health, substance use (opioids and alcohol), sexual health, and suicide)
Chronic diseases and leading causes of death (e.g., heart disease, cancer, chronic lower respiratory disease, cerebrovascular disease, Alzheimer's disease and age-related cognitive impairment, COVID-19) and associated risk factors (e.g., obesity, diabetes, hypertension).
Injury prevention and violence (e.g., sex trafficking, abduction of women in native populations)
Other
9 Does your project address specific population(s)
* must provide value
Yes
No
If yes, please explain:
* must provide value
How will you achieve enrollment targets for this population?
* must provide value
10 Are any community groups involved in the project?
* must provide value
Yes
No
If yes, please explain
* must provide value
11 If applicable, what population health outcomes does your project address?
12 What GP IDeA-CTR services would be beneficial for you to work with
* must provide value
What type of consultation?
What kind of equipment or expertise?
13 What other clinical and translational resources would be beneficial to have access to?
* must provide value
14 Are you using institutional partner resources?
* must provide value
Yes
No
If yes, please select the institution
* must provide value
Other
* must provide value
If yes, what resource(s)?
* must provide value
15 Are you a COBRE/INBRE member?
* must provide value
Yes
No
Name of COBRE/INBRE
* must provide value
17 Does your budget include a subaward?
* must provide value
Yes
No
Who is your departmental budget administrator?
Name of Institution
* must provide value
Name of PI
* must provide value
Institutional F&A rate
* must provide value
* Please submit a subaward budget + justification to be completed by your department research administrator.
Download Budget Sheet (Convert to PDF while uploading)
A Combine all documents as a < bold>
SINGLE PDF in the following order < /bold>
* Indicates a requirement for the Capacity Development Award
Cover Letter*
NIH face page
NIH Biosketches of PI(s) and all key personnel*
Project Summary*
Narrative* (see RFA for required sections)
Letter of Support from partner and/or organization*
References
Human Subjects (if applicable)- this section must also contain Inclusion of Women & Minorities, and Inclusion of Children
Vertebrate (if applicable)
Regulatory Approvals (if available)
Budget and Justification-(use attached budget sheet below)*
Subaward Budget and Justification (if applicable)*
* must provide value
Upload only PDF
Submit
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