Template for RIH Assessment 3
Template for RIH Assessment 3
Ethics application form
Refer to assessments 1, 2 and assessment 3 part 1 to complete the form. Answers should be coherent and consistent with your research proposal.
Refer to the subject module and to The National Statement on Ethical Conduct in Human Research
https://www.nhmrc.gov.au/about-us/publications/national-statement-ethical-conduct-human-research-2007-updated-2018#toc__1114).
The template is an abbreviated template for the purpose of the assessment 3 (Part 2) and should not be used for any other purpose.
Project Overview
Project Title:
Question 1.
Q1.1 Provide a concise summary of the research project that includes research aims, methodology, design, sampling approach, sample, the process of recruitment data collection, management and analysis. An appropriate statement regarding the following: validity rigor trustworthiness should be included. (200 words):
2. Participant Specific Questions
The following questions (2.1-2.2) require short answer responsesP2.1 How will the people participate in this research? (100 words)
2.2. Explain how the research is likely to advance knowledge about the health or welfare or other matters relevant to participants (100 words)
Consent Questions
Tick the most appropriate response to question 2.3-2.4
Q2.3 Which type of consent will you be obtaining from participants to participate in the research?
Informed verbal and written consent
Informed written consent
Informed verbal consent (recorded)
Waiver of consent
Informed implied consent (such as completion of an online questionnaire)
Other (specify)
Q2.4 From whom are you obtaining consent?
The participant
The children or young persons themselves
One parent
Both parents
The guardian or primary care giver
An organisation required by lawWaiver of consent
3. Risk and Benefits Questions
The following questions (3.1-3.3) require that you critically assess and discuss the risks and benefits of your proposed research.
Q 3.1 Describe the risks and burdens to potential participants that are associated with your research, referencing any relevant sections of your Project Description as appropriate and referring to the NHMRC guidelines (100 words)
Q 3.2 Describe how you will mitigate and manage the risks (100 words)
Benefit Questions
Q3.3 In 150 words, justify the benefits to undertake your research and the significance of the proposed research in regard to your research question and implications for practice such as
healthcare practice/policy or service delivery
public health practice/policy
healthcare facilities
broader population
Data and Privacy
Data Characteristics and collection, and storage
Tick the most appropriate response for your study
Q4.1 Indicate the type of information/data you will be collecting for this project.
Personal information
Sensitive information
Health information
Not personal information
Q4.2 Indicate the type of information/data you will be using in this project:
Personal information
Sensitive information
Health information
Not personal information
Q4.3 Indicate the degree of identifiability of information/data you will be collecting for this project.
Individually identifiable information
Re-identifiable (coded) information
Non-identifiable information
Q4.4 Indicate the degree of identifiability of information/data you will be using in this project.
Individually identifiable information
Re-identifiable (coded) information
Non-identifiable information
Q4.5 How will you protect the privacy of participants and their identity during data collection?
Activities Planned for/with DataRefer to NHMRC guidelines.
The following question (4.6) requires a short answer response (50 words)
Q4.6 How will you protect the privacy of participants in any notes and/or publications arising from your research?
The following question (4.7) requires a short answer response (50 words) to justify your Yes or No response.
Q4.7 Are there any restrictions on your ability to assure the confidentiality of participants?
Yes or No and why
The following question (4.8) requires a short answer response (50 words)
Q4.8 Describe how the information/data will be stored, and accessed
The following question (4.9) requires a short answer response (50 words)
Q4.9 Describe any ethical considerations relating to the storage of, access to or destruction of information/data in this project
Reference list
