HSC Society and Culture – P.I.P. Survey
This survey is to help me gain information for my HSC Society and Culture Personal Interest Project (PIP). My chosen topic is the genetic condition, Albinism. I am looking to find out how much is known about the condition in society. Please answer honestly. If you are unsure of an answer or don’t know the answer just leave it black. You will remain anonymous.
1. How old are you?
[ ] 10 – 20
[ ] 21 – 30
[ ] 31 – 40
[ ] 41 – 50
[ ] 50 +
2. Are you male or female?
Male / Female
3. Do you have any connection to someone with Albinism?
Yes / No
If yes, what connection are they to you?
[ ] Family
[ ] Friend
[ ] Colleague
[ ] Patient
[ ] Other, please state: ___________
4. How would you define the term Albinism?
5. Which of the following do you believe people with Albinism have: (you can tick more than one)
[ ] Are completely blind
[ ] Can’t go in the sun at all
[ ] Their eyes shake
[ ] Are deaf
[ ] Cannot have babies
[ ] Are brain damaged
[ ] Have red eyes
[ ] Have white hair and skin
[ ] Are contagious
[ ] Wear sunglasses all the time
[ ] Have psychological problems
[ ] Other, please state: ________________
6. Where have you found your information, if any, on Albinism? (you can tick more than one)
[ ] Research
[ ] Film/TV
[ ] Newspapers/Magazines
[ ] Friends
[ ] Family
[ ] School/Uni
[ ] Other, please state: _______________
7. Would you be interested in learning more about Albinism?
Yes / No
Why? / Why not?
If you saw/met a person with Albinism in public how would you react? (you can tick more than one)
[ ] Stare from a distance
[ ] Shout rude comments at them
[ ] Walk up to them and touch/look at them
[ ] Ask lots of questions
[ ] Not associate with them because of their Albinism
[ ] Whisper about them behind their back
[ ] Ignore them
[ ] Other, please state: _______________
Why would you act this way?
9. ‘People with Albinism cannot integrate into normal society’ (Please circle)
Disagree Agree
1 2 3 4 5
Why do you think this way?
10. ‘Society rejects people with Albinism’
[ ] 10 – 20
[ ] 21 – 30
[ ] 31 – 40
[ ] 41 – 50
[ ] 50 +
2. Are you male or female?
Male / Female
3. Do you have any connection to someone with Albinism?
Yes / No
If yes, what connection are they to you?
[ ] Family
[ ] Friend
[ ] Colleague
[ ] Patient
[ ] Other, please state: ___________
4. How would you define the term Albinism?
5. Which of the following do you believe people with Albinism have: (you can tick more than one)
[ ] Are completely blind
[ ] Can’t go in the sun at all
[ ] Their eyes shake
[ ] Are deaf
[ ] Cannot have babies
[ ] Are brain damaged
[ ] Have red eyes
[ ] Have white hair and skin
[ ] Are contagious
[ ] Wear sunglasses all the time
[ ] Have psychological problems
[ ] Other, please state: ________________
6. Where have you found your information, if any, on Albinism? (you can tick more than one)
[ ] Research
[ ] Film/TV
[ ] Newspapers/Magazines
[ ] Friends
[ ] Family
[ ] School/Uni
[ ] Other, please state: _______________
7. Would you be interested in learning more about Albinism?
Yes / No
Why? / Why not?
If you saw/met a person with Albinism in public how would you react? (you can tick more than one)
[ ] Stare from a distance
[ ] Shout rude comments at them
[ ] Walk up to them and touch/look at them
[ ] Ask lots of questions
[ ] Not associate with them because of their Albinism
[ ] Whisper about them behind their back
[ ] Ignore them
[ ] Other, please state: _______________
Why would you act this way?
9. ‘People with Albinism cannot integrate into normal society’ (Please circle)
Disagree Agree
1 2 3 4 5
Why do you think this way?
10. ‘Society rejects people with Albinism’
Disagree Agree
1 2 3 4 5
Why do you think this way?
1 2 3 4 5
Why do you think this way?
11. Do you think more education on the topic of Albinism would help you/others become more accepting towards people with Albinism?
Yes / No
Why? Why not?
Yes / No
Why? Why not?