Endgame Operational Research Study EOI W eb form

1 8/9/2018 Endgame Operational Research Study EOI Web form - Endgame Operational Research Study EOI Web form Please fill out the form to submit all required Expression of Interest information. Study TEAM. For each investigator involved with this Study please provide name, title, and email contact. Please denote lead PI. PI Name(s) *. Denote Lead PI and Co PI(s) if applicable PI and Co PI(s) Email(s) *. PI and Co PI(s) Title(s) and Institution(s) *. Implementing Partners (Institutions and Country Engagement) *. Please list any collaborating institutions and provide a point of contact (name and email address) associated with each. Also describe the level of engagement, if any, you had with the national or sub national NTD program and/or local researcher when developing this Study proposal.

2 Study DETAILS. Study Title *. Country *. Where will this Study take place? Disease Focus *. Thematic Area *. Please choose one. If more than one option applies, please make a note in the Thematic Area Comments section. 1/5. 8/9/2018 Endgame Operational Research Study EOI Web form - If the Thematic Area is Social Science, explain if the Study is Formative Research or an Intervention Study in the "Thematic Area Comments" section. If the Thematic Area is Diagnostics, list the diagnostic tool(s) to be evaluated in the "Diagnostics to be Evaluated" section. Thematic Area Comments Diagnostics to be Evaluated If the Thematic Area is Diagnostics, please list which diagnostic tool(s) will be evaluated.

3 Diagnostics to be Performed (if applicable). Program Stage Please choose one. Primary Research Question *. Secondary Research Question(s). Has this Research been implemented elsewhere? Background and Significance *. Please describe the problem, citing any evidence from previous Research or program data. Approximately 1 page maximum. If you require more space, please attach a supporting document at the end of this form. 2/5. 8/9/2018 Endgame Operational Research Study EOI Web form - Methods *. For each Research question listed above, please discuss the specific qualitative and quantitative methods and data collection tools to be used. Study Site Study Population Examples include, but are not limited to: Children, Adult Women, Adult Men, Nomads, Migrants, CDDs, the Disabled, the Elderly, Urban Slum Dwellers, etc.

4 Primary Sampling Unit Number of Primary Sampling Units Total Sample Size Analysis Plan *. For each Research question listed above, briefly describe the data analysis plan, what indicators will be used, and how results will be interpreted. 3/5. 8/9/2018 Endgame Operational Research Study EOI Web form - Study Deliverables *. Briefly describe the proposed Study deliverables. Study Start Date *. Study End Date *. Data Collection Method Electronic Paper Mixed Electronic Data Collection Platform If this Study plans to use electronic data collection, please list the platform ( : ODK, REDCap, LINKS) and please note if NTD SC support is needed. Research Translation, Implications and Next Steps *.

5 FINANCING. Estimated Budget Please include a total budget numerical figure only. Budget Comments Please provide a brief overview of the Study budget. 4/5. 8/9/2018 Endgame Operational Research Study EOI Web form - Co funder(s). List co funder(s), if any exist, and describe their contribution(s) to this Study . SUPPORTING INFORMATION. File Upload(s). As applicable, please attach the following supporting documents: 1. NTDSC Budget excel file (template available via email) 2. Protocol 3. Conceptual Framework/Theory of Change for this Study as an image or document file name Upload Send me a copy of my responses Submit Powered by Smartsheet Forms Privacy Policy | Report Abuse 5/5.