RAJIV GANDHI INSTITUTE OF PUBLIC HEALTH AND CENTRE FOR DISEASE CONTROL,

RGUHS, BANGALORE

PROFORMA

PROPOSAL OF RESEARCH STUDY FOR APPROVAL BY THE INSTITUTIONAL ETHICS

COMMITTEE OF RGIPH AND CDC, RGUHS, BANGALORE - 41:

For Post-Graduate Students /Research Scholars

1. NAME OF THE CANDIDATE : PEARL MARIA DSOUZA

Address : RAJIV GANDHI INSTITUTE OF PUBLIC HEALTH

AND CENTRE FOR DISEASE CONTROL

RAJIV GANDHI UNIVERSITY OF HEALTH

SCIENCES, BANGALORE, KARNATAKA

Mobile Number : 7204829983

E-mail ID : pearlmaria23@gmail.com

2. COURSE : MASTER OF PUBLIC HEALTH (HONOURS)

Year of admission and duration : 2015, 3 years

3. NAME OF THE GUIDE : Dr. HARIKIRAN.A.G

Designation : PROFESSOR AND HEAD OF PUBLIC HEALTH

DENTISTRY

DAPMRV DENTAL COLLEGE AND HOSPITAL

BANGALORE

Address : D.A. PANDU MEMORIAL R.V. DENTAL

COLLEGE AND HOSPITAL, CA 37, 24TH MAIN,

1ST PHASE JP NAGAR, BANGALORE-560078

 Mobile Numbers : 9886329121

E-mail ID : docharikiran@yahoo.com

4.NAME OF THE CO-GUIDE/ADJUNCT FACULTY (IF ANY), address, mobile number, Email ID:

None

5. TITLE OF THE RESEARCH STUDY:

ASSOCIATION BETWEEN DEPRESSION AND CIGARETTE SMOKING AMONG I YEAR DENTAL

UNDERGRADUATES IN SOUTH BANGALORE, KARNATAKA: A CROSS SECTIONAL STUDY.

6. AIM & OBJECTIVES:

AIM: To explore the association between depression and cigarette smoking among 1st year
dental undergraduates in Bangalore city.

1. To assess the prevalence of cigarette smoking among 1st year dental undergraduates in

colleges of South Bangalore through a self-administered questionnaire.

2. To assess the prevalence of depression among 1st year dental undergraduates in colleges

of South Bangalore through a self-administered standard depression scale.

7. MATERIAL AND METHODS (IN BRIEF): It is a cross sectional study, where 1st year dental

undergraduates from the selected colleges satisfying the inclusion criteria during the study

period will be interviewed using a pre tested self-administered questionnaire (GATS OR

Faegerstrom Scale). Detailed information regarding depression and cigarette smoking will be

collected. Depression will be assessed using standardized Depression Scale (Becks

depression inventory or PHQ-9).

The tools have been developed in western literature, some of the items in scale may be

customized to suit the local context. After customization the validity of tools will be assessed.

8. Place of study / setting : Dental colleges of South Bangalore

8. Duration of the study (with dates) : 5 months (25-07-2017 31-12-2017)

9. Ethical Issues involved [list out]:

The study does not require any investigations or interventions to be conducted on patients
or other humans or animals. So no other ethical issues involved except for maintaining
privacy, anonymity and confidentiality of the study subjects.

10. How these are addressed in the study [in brief]:

Informed verbal consent will be obtained from the study subjects, who are willing to
participate in the study.

Privacy, anonymity and confidentiality of the informants will be maintained.

11. What is the current status of the study? : In the process of developing a checklist / tool

For the study.

Signature of the candidate

Co-Guide/Adjunct Faculty Guide Head of the Department

[Signature & Seal] [Signature & Seal] [Signature & Seal]

Date: