Appendix I

QUESTIONNAIRE

Section
A: Personal data

Age:
15-25 [ ] 26-36 [
] 37 and above [ ]

Religion: Christianity [
] Muslim [ ] Others [ ]

Educational
status: Literate [ ] Illiterate [ ]

SECTION
B: LIST OF ITEMS

S/N	LIST OF ITEM	A	SA	D	SD
	Knowledge
1	Breast self-examination is a screening method for early detection of breast cancer.
2	Breast self-examination does not need any specialised training or equipment.
3	Lumps, distortions or swelling can be easily detected by breast self-examination.
4	Breast self-examination can be performed from the comfort of your home.
	Attitude
5	Women of childbearing age in Oleh community usually seek for information on how to perform breast self-examination.
6	Breast self-examination is top priority among women of childbearing age in Oleh community.
7	Women of childbearing age in Oleh community usually seek profession advice when they notice changes in their breast.
8	Women of childbearing age create awareness on breast self-examination in the community.
	Practice
9	Women of childbearing age in Oleh community perform breast self-examination regularly.
10.	Husbands in Oleh community encourage their wives to carry out breast self-examination.
11	Women of childbearing age keep a diary of their findings during breast self-examination.
12	Cases of breast cancer among women of childbearing age in Oleh community are usually detected in their early stages.
	Measures to promote
13	Developing effective health education programme can help women of childbearing age in the practice of breast self-examination.
14	Awareness by healthcare professionals can help in promoting the practice of breast self-examination by women of childbearing age.
15	Support from husbands can help to promote the practice of breast self-examination by women of childbearing age.
16	Adequate community mobilization can help to promote the practice of breast self-examination by women of childbearing age.