Download Pilot-test Questionnaire for Breast Cancer Awareness Campaign

Pilot-Test Questionnaire For
Breast Cancer Awareness Campaign
Students from Taylors University College
Rohana Natasya Bt Mohammad Ezan
Siti Sarah Bt Annuar
Siti Ameenah Binti Sallihudin
Samir Mohammed Abdullah
Tang Khong Choong
Researching On
Breast Cancer in Malaysia.
Objective of Research
To increase at least 30% awareness of breast cancer within Klang Valley.
To increase the number of people who goes for mammogram checkups by 50%.
Purpose of Research
The purpose of the research is to conduct a One Year breast cancer awareness campaign
throughout Malaysia.
Confidentiality
For academic purpose only
(Individuals are allowed to withdraw if they feel uncomfortable)
Point of Contact
Rohana Natasya: 019 - 6598584
Siti Sarah Annuar: 012 – 3511368
Siti Ameenah Sallihudin: 013 - 3888988
Samir Mohd Abdullah: 013 – 3010474
Tang Khong Choong : 012 – 3027761
Demographic
1. What is your age group?
A. 20-30
B. 31-40
C. 41-50
D. 50 and above
2. What is your race?
A. Malay
B. B. Chinese
C. Indian
D. Others
3. Where are you from?
A. Central Region
B. East Coast
C. Northern Region
D. Southern Region
4. Highest education level?
A. SPM
B. Diploma
C. Degree
D. Others
5. Any history of breast cancer in your family?
A. Yes
B. No
Awareness
1. Are you aware of the symptoms of breast cancer?
A. Yes
B. No
2. Breast cancer treatment is long and painful process?
A. Agree
B. Disagree
3. Which of the following may decrease the risks of developing breast cancer?
Check all that apply.
o Moderate sun exposure
o Amount of sleep
o Breastfeeding
o Having children before you are 30
o Eating fruits & vegetables
o Physical exercise
o Being on the pill
o Hormone replacement therapy
o I don’t know
4. Do you think it is possible to dramatically decrease your risks of developing breast
cancer with one simple change?
A. Yes
B. No
C. I don’t know
5. Please tick the right option among the following that is applicable to you.
A. I wear bra all day long
B. I wear only during the day
C. I do not wear bra
D. I wear bra for less than 12 hours
E. I wear bra for slightly more than 12 hours
Choices of Media
1. Which of the following choices of media provides you with the latest news and
information regarding what is happening the society?
A. Television
B. Newspapers
C. Radio
D. Magazines
E. Online Social Networks (Facebook, Twitter, Blogs, etc)
2. What type of newspaper do you read?
A. The Star
B. Utusan Malaysia
C. Sin Chew Daily
D. Nesan
E. New Straits Times
F. Harian Metro
G. Nanyang Siang Pao
H. Makkal Osai
3. Do you listen to radio?
A. Yes
B. No
4. Are you aware on campaign regarding breast cancer awareness from the radio show?
A. Yes
B. No
5. Do the media provide you with adequate information to understand breast cancer
thoroughly?
A. Yes
B. No
Activities
1. Did you participate in any events/activities before to promote breast cancer awareness?
A. Yes
B. No
2. Would you be interested in activities to promote awareness regarding breast cancer?
A. Yes
B. No
3. What type of activities would you prefer?
A. Indoor
B. Outdoor
4. How regular do you think our activities should be held?
A. Monthly
B. Quarterly
C. Semi-Annually
D. Annually
5. Which type of activity would like to participate in?
A. Fundraising
B. Public Talk
C. Educational Retreats
D. Charity Concerts