Lay involvement in research application form

If you would like to connect with people affected by pancreatic cancer who can help shape your research, please complete the application form below and the Research Team will get in touch about your involvement opportunity.

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Your details

Title(Required)

Name(Required)

Pronouns

Email(Required)

Please check this box to confirm that you are happy for us to share your email address with network members who might want to get in touch with you about this opportunity(Required)

I confirm

Institution(Required)

Study details

Please be sure NOT to include any confidential information, as this summary may be published on Pancreatic Cancer UK’s website

Scientific Title of Project(Required)

Who is conducting the research?(Required)
Please name the Principal Investigator and any co-applicants or collaborators

For the following questions, please use plain English and no jargon; so that it is easy for someone without a scientific background to understand.

Lay Title of Project(Required)

Describe your project in a one or two sentence, ‘in a nutshell’, summary(Required)

What is the project about?(Required)

What are you going to do? (Brief methods)(Required)

Why is this important and how could the outcomes make a difference to people with pancreatic cancer?(Required)

Study funding and ethics
Is your project funded or is it pre-funding?(Required)

Pre-funding

Funded
Name of funder(Required)
Do you have a deadline by which this involvement opportunity needs to take place?(Required)
Deadline for application submission(Required)
When will outcome be known?(Required)
Is the research being funded by a pharmaceutical company?(Required)

Yes

No
Please state the proportion of funding(Required)
Does the project require ethics or research governance approval?(Required)

Yes

No
Has this been approved?(Required)
Please justify why ethics/governance approval is not required(Required)
Does the project require any non-disclosure agreement?(Required)

Yes – upload

No
Non-disclosure agreement upload
Accepted file types: pdf, docx, Max. file size: 3 MB.

Opportunity Details
Type of research involvement (please tick all that you would like to request)(Required)
Document review
Focus group discussion
Steering committee or patient advisory group
Survey or questionnaire
Event
Other
We are able to send your document with 8-10 questions that you would like participants to answer. Please select and/or add any questions you would like us to send with your documents.
Please upload the document you wish to be reviewed
Max. file size: 50 MB.

Document review questions(Required)
Do you understand the intended outcome of this project?
Is the language accessible, or are there terms that you have to look up? Please specify specific phrases or words that you think are unclear.
Is the figure detailed enough/too detailed to explain the concept of the proposed work?
Are there any questions that you come away from reading this wishing you could ask?
Do you think this work is important/relevant to people with pancreatic cancer? Please explain your answer.
Are there any aspects of the proposal that you think should be changed to make the work more acceptable to patients or their families?
Is the plan for patient and public involvement throughout the project appropriate?
Do you have any other comments?
Do you have any other questions you would like us to ask reviewers? Please add them below(Required)
When would you like to hold the focus group?
Evenings can tend to work better to be inclusive to all of our RIN. Please provide an exact or estimated date and time
Please give details below about the level of involvement required for your steering committee or patient advisory group
How often will the group meet? What is the duration of the meetings? Will the meetings be virtual, in-person or both? If in person, where will they be. How many individuals will you be looking to recruit?
Add link to survey
When would you like to hold the event?
If none of the previous options fit the type of involvement you would like please get in touch with the Research Team on research@pancreaticcancer.org.uk
Who can take part/who is the opportunity aimed at?
(i.e. is this open to anyone affected by pancreatic cancer including patients, survivors, carers and loved ones?)
consent for feedback
Please check this box to confirm you will provide feedback to Pancreatic Cancer UK and a short thank you email response to RIN members for their involvement after your opportunity has taken place.
How will you provide feedback to Pancreatic Cancer UK and the people who got involved in your project regarding how their involvement has made a difference to your project and of the outcome of the research?(Required)

Other details
Is this opportunity virtual or in person?
In-person
Virtual
In-person – please outline what expenses will be paid to cover travel(Required)
Will you be offering any incentives for involvement? (Please refer to the guidance and tools for involvement on our webpage)(Required)
Is insurance cover in place for participants? (Please give details if applicable)
What steps will be taken to ensure that information about participants is stored and used in compliance with the provisions outlined in the Data Protection Act 1998?
Confirmation(Required)
I understand that if this form is submitted after 20th of the month my involvement opportunity will likely not feature in the next months bulletin
I confirm that I have completed all relevant sections of this form and would like to submit my application to Pancreatic Cancer UK’s Research Team to advertise my involvement opportunity in the Research Involvement Network bulletin
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