SHARC Concept Submission Form

SHARC welcomes collaborations with investigators both nationally and internationally. The efforts of investigators in collaboration with SHARC have produced research and publications of significant scientific merit, not only in the study of HIV/AIDS, but in public health.

Investigators are encouraged to submit ideas for research via an online Concepts submission process. There are two parts to this form:

1) Administrative information related to your Concept and 2) Uploaded Concept Research Plan.

Prior to Concept submission, prospective investigators are encouraged to review their proposed research with either a SHARC Faculty Mentor (for internal investigators) or a SHARC collaborator (for external investigators). If you have any questions related to the Concepts submission process, please contact the SHARC Concepts Administrator at sharcconcept@gmail.com.

Lead Investigator*

PrefixFirst NameMiddle InitialLast Name

Preferred First Name

If different from your legal first name

Email*

example@example.com

Telephone Number*

Area CodePhone Number

Institution*

Is the Lead Concept Investigator currently a student?*

YesNo

If a student, provide the name of the Faculty Mentor*

First NameLast Name

How is the Lead Concept Investigator affiliated with SHARC?*

NOTES: If neither the Lead Concept Investigator nor the Faculty Mentor is a SHARC Core Faculty member, the Concept Research Plan requires review and approval by a SHARC Core Faculty member prior to submission. Please provide the name of the SHARC Core Faculty member below.

SHARC Core Faculty Mentor*

First NameLast Name

Concept Title*

Study Aims*

Key Words*

Research Project from which data is requested*

Florida Cohort (Phase I)Florida Cohort (Phase 3/Wave 3)30-Day ChallengeMAPLE StudyWHAT-IFSHARC Research Contact RegistryMerged data from multiple studies (please specify below the studies from which data is requested)

For merged data requests, specify all projects from which data is requested: (Check all that apply)*

Ancillary Project involving the collection of new data is requested: (Check all that apply)

Additions to existing questionnaireAdditional clinical and physical measuresAdditional project module

NOTES: SHARC data may include variables (e.g., viral load, HIV care continnuum variables from medical records, etc) from the linked HIV surveillance data from the Florida Department of Health (FLDOH).

Any Concept involving FLDOH data will be submitted to FLDOH for review and approval. A FLDOH data user agreement is required prior to data sharing.

Principal Investigator of the study*

First NameLast Name

Participant Eligibility Criteria*

Working Group Members*

List the full names of all Co-Investigators including Faculty Mentor, SHARC Mentor and others.

Have all the Working Group members reviewed and approved the Concept Research Plan?*

YesNo

Submission Types

PreConcept: Request that defines a few variables for a sample dataset to be analyzed with the objective of developing a Concept
Initial Concept: New/Original submission
Revised Concept: An updated or strengthened Concept submission

NOTE: If the Concept proposes new aims, substantially different data elements to be collected and/or analyzed, a significantly expanded scope, sub-studies, or will result in the publication of an additional manuscript, a new Initial Concept must be submitted.

Submission Type*

PreConceptInitialRevision

If this is a revision, please provide the original Concept ID number and a summary of changes.

Concept ID*

Required for revision

Summary of changes *

Required for revision

Concept Research Plan

Please submit your research plan, including detailed approach to data analysis, using the template: SHARC Concept Research Plan Form. Once complete, upload the form as a single PDF file using "LastName_Date" as the file nomenclature. If this is a revision, upload the research plan with highlighted or tracked changes/revisions.

Upload the Concept Research Plan (must include detailed approach to data analysis and must identify the Concept Investigator or Co-investigator who will be responsible for performing the data analysis)*

Browse Files

Will the Concept Investigator require subject area expertise from outside the proposed Concept Working Group to analyze one or more variables specified in the Concept? Please identify the subject area in which expertise is needed. *

(If additional subject area expertise is not needed, please indicate N/A in the space above.)

Upload the Faculty Mentoring Plan for the Lead Concept Investigator if s/he is a student or staff member. (The Faculty Mentoring plan is a communication from the student's Faculty Mentor or a SHARC Core or Affiliate Faculty Mentor to affirm that s/he has full knowledge of the proposed Concept and is available to guide the student Concept Investigator in carrying out the research.)

Browse Files

Before submission, please review, acknowledge, and agree to the following:*

I have reviewed and agree to abide by the SHARC Concept and Publication Policies and Procedures.All information that I provide in this Concept is complete and correct as submitted.Use of data or specimens is restricted to the aims outlined in the Research Plan.IRB approval has been, or will be, obtained before any data and/or specimens are received.I will complete a SHARC Data Use Agreement (DUA) if this proposal receives approval and requires one.Abstracts resulting from approved Concepts MUST be submitted to SHARC for approval prior to submission to a conference. Manuscripts must be submitted to SHARC for approval prior to submission to a journal.Under no circumstances will I make any SHARC data study subject ID number public in either documents or presentations, e.g., journal articles, abstracts, oral or poster presentations, or on any website.The Lead Concept Investigator for each approved Concept must submit a quarterly progress report. If no progress report is received after two email reminders, approval for the Concept will automatically expire.My signature below indicates a complete review and acceptance of the guidelines for collaborations, publication, and acknowledgment as outlined in the policies and procedures manual.

Signature*

Date

Please provide any additional information that is important to the review of this Concept.