Research or Related Information Concept Submission Form

The Concept Submission Program process is designed to collect information on evidence-based services, products, programs and research that support service members and their families and is available to the general public. The information that a collaborator shares about products or services must be related to psychological health and/or traumatic brain injury.

By completing the submission form, you are agreeing to have your submission reviewed by a representative of Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) who may wish to contact you for further information related to your submission.

DCoE does not award contracts, provide research grants or offer other forms of financial support.

DCoE does not purchase programs, services or products through the concept submission process.

If you are seeking funding, please visit: http://www.usamraa.army.mil/pages/baa_forms/index.cfm

For grant announcements, please visit: www.grants.gov

Research or Related Information Concept Submission Form
Title of Research:
This research was funded in whole or in part by:	Veterans Administration Department of Defense Other
If funded by "Other", please describe:
Referred by:
By whom?:
Contact Information:
Organization Name:
Lead Individual’s Name:
Street Address:
E-Mail:
Phone:
Website: (If applicable)
Topic Areas:
(Check 4 most closely associated)
ResilienceRehabilitationReintegrationPTSD PreventionEducationEmployment/VocationalDepression ScreeningTrainingSuicide PreventionSubstance Abuse DiagnosisAftercareMental IllnessRelationship Issues GuidelinesQuality of LifeTBIDomestic Violence Mitigation
Other Topic Area:
Population that would benefit from this information:
(Check 4 most closely associated)
Active DutyLeadersChaplainsNurses VeteransUnitsMental Health ProvidersOther Health Providers FamiliesCommunitiesPrimary Care ProvidersCase Managers ChildrenSchool PersonnelMedics/CorpsmenResearchers Spouses
Other Population:
What is the purpose of this submission? What do you hope to gain as a result of this concept submission? (e.g. "Request dissemination of this research throughout DoD" or "Request DCoE be aware of our recent study that shows improved outcomes for PTSD/TBI") (2000 word limit)
Focus of Study (e.g. What was studied? What were the results? What are the implications for populations of interest to DCoE?) (2000 word limit)
Demographics (e.g. "This study examined active duty Service Members post-deployment" or "This study examined inpatient treatment of adolescent military family members ages 12-18 with mood disorders") (2000 word limit)
Dissemination (e.g. Has the research been presented? Where/When/Outcomes) (2000 word limit)
Future activities/plans (e.g. "We are presenting this research to _____" or "We are refining/expanding our research to consider _____” or "We have applied for a grant with _______.”) (2000 word limit)
Additional information DCoE should know (2000 word limit)
Evidence to Support Research
Please list supporting empirical evidence. If anecdotal evidence please list as such.
Randomized Controlled Studies: (citation or short paragraph for each or Not/Available)
Case Studies/Case Reports/Anecdotal Evidence: (Citation or short paragraph or N/A)
By completing the submission form, you are agreeing to have your submission reviewed by a representative of DCoE who may wish to contact you for further information related to your submission. DCoE does not award contracts, provide research grants or offer other forms of financial support. DCoE does not purchase programs, services or products through the concept submission process. If you are seeking funding, please visit: http://www.usamraa.army.mil/pages/baa_forms/index.cfm For grant announcements, please visit: www.grants.gov

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Concept Submission Program

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