Implementation of Diabetes Food Insecurity Screening

| July 20, 2015



Write approximately one paragraph that describes the action research project and the basis for it being addressed.



2 Contribution to Society


Using citations, answer the following questions in order:


1. How does your project improve a current practice?


2. If your action research project is successful, how could your project impact your field of interest?


3. What are the practical implications of your project? For example, what will be the impact of this project on your sample, your site location, or your workplace?



3 Need and Evidence to Make Change


Provide current information on your needs assessment or analysis for change. Include the cost-benefit analysis if indicated by design.



4 Theoretical Foundation


Describe the theory or theories that serve as the backbone of your project. Provide references for each theory.



5. Researcher Positionality: as an


•Insider w/collaboration


Define your role, position, and how positionality will impact your research study.



6 Research Questions and Project Goals/Objectives


List the research questions or project goals.


Will implementing a screening for diabetes food insecure lead to better management of glycemic control in TYP2D?”,


“Is diabetes food insecurity the reason for poor glycemic control for low income patients?”,


“What’s the connection with Food Insecurity and Diabetes

These should align with the need for organizational structure or activities/outcomes of the project.



7. Action Plan


Provide detailed steps to implementing your research plan. This should read like a recipe for conducting your project.

Be sure to include all the necessary details so that someone else would be able to follow this and replicate the project exactly.





Describe your program evaluation and dissemination of results plan.



8. Measures and Instruments


List and describe each data collection instrument or measurement tool you will use. This includes questionnaires, formal interview protocols, forms, etc. Include:


I will be using surverys

a.Data type(s) generated by each measure

b.Available psychometric information (including validity and reliability coefficients)

c.How this data will be used


Attach a copy of each instrument you plan to use as an appendix to your SMART form.



8 If Modifying an Instrument:


Describe any pilot test or field test that may be required for any instruments. Type NA if not applicable. Field tests must be done:


The learner will be doing a Field test


a.For new instruments or questions developed by the learner.

b.With expert panelists. Field tests require no IRB review. A pilot test requires IRB review.



9. Assumptions


Identify the key assumptions of the project; use citations to support their adoption.



10. Limitations


Evaluate the weaknesses of your project at this time. Indicate areas to be improved before starting your project and areas that cannot be improved. Give reasons for not redesigning to address any of the limitations identified.



11. Population and Sampling


Describe the key stakeholders or population of your project. Briefly describe the characteristics of this sample, including:



b.Inclusion criteria, if any

c.Exclusion criteria, if any


Describe how you plan to select the sample. Include the steps you will take to include participants.



12. Sample Size


What is the expected sample size? Provide citations to support the sample size decision.



13. Data Analysis


Describe analysis procedures for each data type including: audiotapes, transcripts, videotape, field notes, photos, descriptive analysis, other quantitative analysis, etc.


Describe all methods and procedures for data analysis including:


a.Types of data to be analyzed

b.Organization of raw data

c.Management and processing of data

d.Preparation of data for analysis

e.Storage and protection of data



14. Ethical Considerations


Describe any ethical considerations given the sample population and/or topic. Please explain as fully as possible.


Describe any ethical concerns about defined researcher positionality. Address any potential for coercion.



15. Risk Assessment


Is your study more than minimal risk?  Please explain.

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