Infectious Disease KAP Survey
Please complete this survey to help us understand your knowledge, attitudes, and practices regarding infectious diseases. Your responses are confidential and will only be used for research purposes.
Demographic Information
Full Name
First Name
Last Name
Age
*
Gender
*
Male
Female
Prefer not to say
Non-binary/Other
Education Level
*
Please Select
No formal education
Primary school
Secondary school
High school
Vocational/Technical
Undergraduate degree
Postgraduate degree
Other
Occupation
*
Please Select
Healthcare worker
Student
Teacher
Office worker
Manual laborer
Unemployed
Retired
Other
Knowledge Assessment: Please indicate whether the following statements are True or False.
*
Rows
True
False
Infectious diseases can be spread by coughing or sneezing.
1
2
Hand washing helps prevent infectious diseases.
3
4
All infectious diseases can be treated with antibiotics.
5
6
Vaccines can protect against some infectious diseases.
7
8
Attitudes: Please indicate your level of agreement with the following statements.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am concerned about getting an infectious disease.
9
10
11
12
13
I believe infectious diseases are a serious threat to my community.
14
15
16
17
18
I feel confident in my ability to protect myself from infectious diseases.
19
20
21
22
23
Practices: In the past month, how often have you performed the following actions?
*
Rows
Never
Rarely
Sometimes
Often
Always
Washed your hands with soap and water.
24
25
26
27
28
Worn a mask in crowded places.
29
30
31
32
33
Avoided close contact with people who are sick.
34
35
36
37
38
Sought medical attention when experiencing symptoms.
39
40
41
42
43
How do you prefer to receive information about infectious diseases?
*
Television/Radio
Social media
Healthcare professionals
Family/Friends
Printed materials (flyers, posters)
Other
If you would like to share any additional comments or suggestions, please write them below:
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