HOP Request Intake

Please complete this form with details of your request. Following submission, you will be contacted by a member of the HOP team to confirm the details of your request.

For general inquiries, contact Wesley Stoller:

stoller@ohsu.edu

Project Title

Contact Information

Project Lead

Project Lead Email

Request Contact

*if other than Project Lead

Request Contact Email

*if other than Project Lead

Key Collaborator

*if applicable

Key Collaborator's Email

*if applicable

Request Details

Are you requesting aggregate data or data about our sample inventory?

NOTE: Aggregate does not include individual-level data. This type of request is for descriptive purposes only.

Yes

Are you requesting access to individual-level data or samples?

Please answer "yes" if you plan to use any HOP data for analysis.

Yes

Are you requesting recruitment assistance?

Please answer "yes" if you plan to use our participant population to enroll into your standalone study.

Yes

Are you requesting the addition of a survey to the HOP app?

Yes

Is your request part of a larger grant application?

Yes

What type of request are you submitting?

Data/sample inquiry

Data/sample use request

Survey addition

Recruitment assistance

Survey Considerations:

Survey additions also require a data use request in order to access the data collection from the new survey. Please select both options, or indicate below that this request is to study the feasibility of adding a survey and a data request will be submitted once a decision has been made to implement the survey.

HOP is an phone-based app. It is not suitable for long surveys (>20 items), games, or surveys with highly complex skip patters.

Study Description

Please provide a brief summary of your project.

Name of the survey you would like to add:

NOTE: Please upload a copy of this survey at the end of this submission form.

Is this survey in the public domain (free to use in any form)?

Yes

Have you obtained a license to use this survey?

NOTE: if yes, please upload a copy of your licensing agreement at the end of this submission form.

Yes

Data Description

What data do you need from HOP? Please be as specific as you can.

Data Type

What level of detail do you need in your data report?

Summary Data (e.g. percentages, participant counts)

Participant Level Data

Participant Numbers

If applicable, please specify how many participants' data or DNA is needed. If you have no requirements, enter N/A.

Recurring?

Yes

Will you compensate subjects for survey completion?

Yes

Sample Volume

Please indicate sample volume needed per participant, in μg.

Associated Data

Please describe any data needed for your requested samples (e.g. demographic information, mutation status, HOP survey data).

IRB Considerations

HOP requires evidence of IRB oversight for any requests involving identifiable data or genetic research.

If you are a collaborator on the HOP IRB protocol, your project may require additional IRB approval.

Once your request is approved by the HOP team, we will provide guidance on any IRB requirements and how to obtain IRB approval.

Are you a collaborator on the HOP IRB protocol?

Yes

Are you requesting identifiable data on HOP participants?

Yes

Are you conducting genetic research?

This includes research involving DNA specimens, genetic testing, or genetic information.

The IRB's definition of genetic research is broad, and includes any research involving DNA, RNA, and proteomics IF the protein being investigated is thought to be controlled by a genetic trait.

Yes

Costs & Funding

Is this a CEDAR funded project?

Yes

Fee Waiver

HOP charges $50/hour for repository services, including:

data report preparation
recruitment for other studies
survey addition to HOP app
DNA sample pulls

If you have a reason you feel the fee should be waived, please include it below.

Yes

Send me a copy of my responses

Report Abuse