Finalizing Survey

We have been making changes to our survey and think we are about ready to distribute it. We still need to make a few changes and have Kami go over it. We've been trying to decide where to go to distribute them and will probably go to a rec center, maybe a walmart, and a mall like the gateway where there will be a lot of people around.
Survey
1. M F
2. Circle you’re age range.
18-29 30-39 40-49 50-59 60+

3. Which of the following best describes periodontal disease? (looking for an understanding of how sophisticated their knowledge is of perio)

A disease in the mouth Red and bleeding gums Destruction of oral bone
Don't know

4. Circle below the cause of periodontal disease?
Poor oral hygiene Genetics Bacteria Age

5. Which of the following best describes a stroke?
Heart attack Blood clot in the brain Brain disease

6. Circle the contributing factor to stroke?
Smoking Diet Exercise None of the above All of the Above

7. Do you think that an infection in your mouth can cause problems in the rest of your body?
Strongly disagree disagree neutral agree strongly agree

8. Did you think there is a correlation between periodontal disease and stroke?
Strongly disagree disagree neutral agree strongly agree

9. Do you think a stroke affects other parts of the body?
Strongly disagree disagree neutral agree strongly agree

10. After taking this study, would you be interested in learning more about periodontal disease?
Not interested Neutral Interested




Do you know what perio is?
3, 4, 5,
Do you know what stroke is?
6, 7,
Do you know there is a correlation between stroke and perio? 8, 9,
Demographics: 1, 2
Needs assessment: 10

Skye & Casandra 3 Hours