Sample of Questionnaires: Sample of Survey Questions in Research

Sample of Questionnaires

The sample of questionnaires has been collected from University Putra Malaysia. New researchers will get a concept on how to create a survey questionnaire. This sample of questionnaires represents an example of questionnaires.

The author has uploaded some different samples of questionnaires and set download links here so that readers download the pdf form. This sample of questionnaires might provide a better level of understanding for the new researchers.

Sample of Questionnaires Download Link
  1. Sample of Questionnaire 
  2. Sample of Questionnaire
  3. Sample of questionnaire
Sample of Questionnaires

Dear respondent,

We are KOM3431 Communication Research Students from the Department of Communication, Faculty of Modern Languages, and Communication. We are currently doing our individual assignment on data analysis. We wish to collect some information about your awareness of obesity.

You are invited to participate in this survey in which your insight and information are valuable for us to strategize the health communication campaign to be more effective. We greatly appreciate your help in providing us your honest answers to the questions below. I reassure you that the information gathered in this survey will only be used for event purposes and will be kept confidential.

Thank you.

1 Ethnic : □ Malay □ Indian
2 Gender : □ Chinese □ Other: ______________
□ Male □ Female
3 Age : Below 15 31–35
15–19 36–40
20–25 41–45
26–30 Above 45


  1. Which written language(s) do you understand? (Choose whichever relevant)
Malay English
Chinese Tamil


  1. Which spoken language do you prefer? (Choose one (1) ONLY)
Malay English
Mandarin Tamil
Cantonese Hakka
Hokkien Other: ___________
  1. What are the main sources you use the most to obtain health information? (Choose minimum one (1) answer and maximum three (3) answers)
Newspaper Internet
Magazine Facebook
Television Instagram
Radio Twitter
WeChat Other: ______________


  1. If you have selected a newspaper as one of the sources for obtaining information pertaining to health, which newspaper vehicle do you read the most? (Choose one (1) ONLY)
Sin Chew Daily Guang Hwa Daily
China Press Oriental Daily
Nanyang Siang Pau The Star
Utusan Malaysia Berita Harian
Kosma! News StraitTime
Guang Ming Daily Other: ______________
  1. Do you watch local television (TV) station(s)?
  • Yes (Proceed to Q2)
  • No (Proceed to Q4)
  1. How many hours of TV do you watch in a day? (Choose one (1) ONLY)
  • Less than 1 hour per day
  • 4-6 hours per day
  • 1-3 hours per day
  • More than 6 hours per day
  1. Which TV channel you watch the most? (Choose one (1) ONLY)
Astro NTV 7
RTM 2 TV 9
TV 3 Other: ______________


  1. Do you listen to the local radio?
  • Yes (Proceed to Q5)
  • No (Proceed to Q7)
  1. How many hours of local radio station do you listen in a day? (Choose one (1) ONLY)
  • Less than 1 hour per day
  • 1-3 hours per day
  • 4-6 hours per day
  • More than 6 hours per day
  1. Which local radio station you listen to the most? (Choose one (1) ONLY)
One FM Hitz.FM
988 FM Fly FM
Melody FM Lite FM
Ai FM Era FM
Red FM Hot FM
Sinar FM Other: ______________


  1. Which social media do you use the most? (Choose one (1) ONLY)
Facebook Twitter
Instagram WeChat
WhatsApp Other: ______________

SECTION DAwareness about Obesity

Tick (✓) the spaces provided to indicate your level of agreement with the statements below.

I. Problem Recognition
No Statements Strongly



2 3 4 Strongly



1 Obesity is becoming an increasingly large problem in my community.
2 There is an urgent need to solve the obesity problem in my community.
3 There is much room for local authorities and the government to improve the policies in controlling obesity in Malaysia.
4 I believe the prevention of obesity is very important.
II. Constraint Recognition
No Statements Strongly



2 3 4 Strongly


1 I am not able to do anything to solve the obesity problem in my community.
2 My efforts to combat the obesity problem in my community is pointless.
3 I do not see any points in trying to encourage my community members to control their weights.
4 I think I could not affect my community members to control their weight and to prevent obesity.
III. Involvement Recognition
No Statements Strongly



2 3 4 Strongly



1 I am concerned that overweight is affecting my life.
2 I believe obesity could affect my health.
3 I have a strong opinion about obesity.
4 I feel that obesity affects me personally.

– – End of Survey Questionnaire – –

Thank you for answering.

Research Methodology: Measurement Scale and Level, Reliability & Validity

Research Methodology Measurement Scale & Level

Level of measurement

A deadly magnitude 7.3 earthquake had struck Nepal in April 2015. GST is charged and levied on any supply of goods and services made in Malaysia at 6%.

  1. Nominal
  2. Ordinal
  3. Interval
  4. Ratio

Scales of measurement

  1. Nominal scale
  • Categorical variable
  • Represented by number
  • E.g., gender, employment status, religion, etc.
  1. Ordinal scale
  • Rank variable (highest to lowest…)
  • Distances among scales are different
  1. Interval scale
  • The difference between the two values is meaningful
  • Distances among scales are identical
  1. Ratio scale
  • True zero
  • Differences between values can be compared meaningfully


Needs to be:

  • Unidimensional
  • Linear (equal intervals)
  • Reliable
  • Valid
  • Research Methodology Measurement Scale

Research Methodology Measurement Scale

Simple Rating Scale
  • (1) to rate list of items or (2) to rate how much respondents
  • like smtg.
  • 1-3? 1-5? 1-7? 1-10? 1-100?
  • For greater differentiation
  • The higher the number, the more you agree/like
Thurstone Scale
  • Psychologist Robert Thurstone
  • Equal-appearing intervals
  • 11-category scale
  • Neutral statement
Likert Scale (summated rating approach)
  • Psychologist Rensis Likert
  • Strongly agree, agree neutral, disagree and
  • strongly disagree
Semantic Differential Scale

How would you rate your mother on these scales?


  • “the degree to which a test measures what it is supposed to measure”
  • Fundamental consideration


  • “the degree to which a test consistently measures whatever it is measuring”
  • Fundamental consideration.
Types of validity
  • Face validity
  • Content validity
  • Criterion-related validity (1. concurrent validity & 2. predictive validity)
  • Construct validity
  • Discriminate validity
  • Consequential validity
  1. Face validity
  • Subjective assessment / a subjective judgment
  • For instance, you might look at a measure of math ability, read through the questions, and decide that YES, it seems like this is a good measure of math ability (i.e., the label “math ability” seems appropriate for this measure)

2. Content validity

  • To which a test measures an intended content.
  • TWO types: item validity – whether the test items are relevant to the measurement of the intended content area & sampling validity
  • –how well the test samples the total content area being tested.
  • E.g., being a good science teacher
  • A test score cannot accurately reflect a student’s achievement if it does not measure what the student was taught and is supposed to have learned.
  • Determined by expert judgment (content validation)

3. Criterion-related validity

  1. Concurrent validity

“the degree to which scores on one test are related to scores on a similar, preexisting test administered in the same time frame or to some other valid measure available at the same time.”

  1. Predictive validity
  • “the degree to which a test can predict how well an individual will do in a future situation.”
  • For example, the Graduate Record Examination (GRE), International English Language Test System (IELTS), etc.

4. Construct validity

  • “What is this test really measuring?”
  • Constructs underline the variables that researchers measure. You cannot see a construct; you can only observe its effect.
  • convergent validity – Correlation test (Pearson)
  • discriminate validity -Factor analysisConvergent Validity


Dependability or trustworthiness

  • “the degree to which a test CONSISTENTLY measures whatever it is measuring”
  • Is expressed numerically – reliability coefficient (correlation) *1.00
  • Internal consistency reliability
  • Cronbach’s alpha 70% and above
  • Test-retest, Kuder-Richardson 20 (KR 20), split-half reliability