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Indoor Air Quality

Biological Pollutants Lesson Questionnaire

At the beginning of the lesson:

Ask participants to raise their hands if any of the following five questions are true. Please record the number of persons raising their hands to each question.

• How many of you have someone with hay fever in your family? _____
• How many have a family member with asthma? _____
• How many have a family member allergic to pets, dust mites, mold or pollen? _____
• How many think people have more allergies these days than in past times? _____
• How many of you who have family members with allergies use some strategies to reduce the allergen levels? _____

At the end of the lesson:

• If you have a family member with allergies or asthma, do you plan to make any changes in your cleaning strategies to help reduce the allergen level? _____
• As a result of today’s lesson, do you plan to make changes in your household living style (such as utilizing vent fans, etc.)? _____
• What changes do you plan to make? Ask a few of those who raise their hands what they plan to do and record the comments here.
  _____________________________________________
  _____________________________________________
  _____________________________________________
  _____________________________________________
• Do you plan to pass information along to someone you know who might need it? _____
  If yes, who do you plan to give it to? Record their responses here.
  _____________________________________________
  _____________________________________________
  _____________________________________________
  _____________________________________________

After the lesson:

Please fill in the following information and copy this questionnaire (front and back). Return this questionnaire, with the marked responses, to Janie L. Harris, Extension Housing and Environment Specialist, 2251 TAMU, College Station, Texas 77843-2251.

Number of participants in each age group?

• 18 to 24 years _____
• 25 to 40 years _____
• 41 to 55 years _____
• 56 to 65 years _____
• 65 plus years _____

Number of participants of each sex?

• Male _____
• Female _____

Type of group (FCE, youth group, civic group, etc.):
________________________________________

County: _________________________________

Date of program: __________________________

Your name and telephone number:

Name: __________________________________

Telephone number: ________________________

Other comments:

 

 

 

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Prepared by Janie L. Harris, M.Ed., CRS, Extension Housing and Environment Specialist, Texas AgriLife Extension Service, Texas A&M System. 1999.

Last updated: 26 July, 2010

Educational programs of the Texas AgriLife Extension Service are open to all people without regard to race, color, sex, disability, religion, age, or national origin.