Q01
Message
All templatesEducation & Academic
Dissertation Attitudes and Behaviors Research Questionnaire
A general-purpose Likert-scale instrument skeleton for graduate dissertation research, pairing validated-style attitude, norm, and intention batteries with an AI follow-up that probes the reasoning behind attitude-behavior gaps. Built for thesis researchers to adapt with their own constructs; demographics are collected last for clean subgroup analysis.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
14 questions · ~7 min
Q02
ConsentRequired
Before we begin, please review this brief consent statement.
Q03
MatrixRequired
Please indicate how much you agree or disagree with each statement about [construct name].
4 rows × 5 columns
- (Replace with your construct items) I believe [construct] is beneficial.
- (Replace with your construct items) I feel positively about [construct].
- (Replace with your construct items) [construct] is relevant to my daily life.
- (Replace with your construct items) Overall, my attitude toward [construct] is favorable.
Columns: Strongly Disagree · Disagree · Neutral · Agree · Strongly Agree
Q04
MatrixRequired
Please indicate how much you agree or disagree with each statement about the people around you and this topic.
3 rows × 5 columns
- (Replace with your construct items) People who are important to me think I should engage in [behavior].
- (Replace with your construct items) Most people I respect would approve of me doing [behavior].
- (Replace with your construct items) I feel social pressure to engage in [behavior].
Columns: Strongly Disagree · Disagree · Neutral · Agree · Strongly Agree
Q05
MatrixRequired
Please indicate how much you agree or disagree with each statement about your intentions.
3 rows × 5 columns
- (Replace with your construct items) I intend to engage in [behavior] in the next month.
- (Replace with your construct items) I plan to make an effort to engage in [behavior].
- (Replace with your construct items) I am confident I will engage in [behavior] when the opportunity arises.
Columns: Strongly Disagree · Disagree · Neutral · Agree · Strongly Agree
Q06
Opinion ScaleRequired
Overall, how would you rate your attitude toward [topic]? (Template note: replace bracketed topic with your construct of interest.)
Scale: 1 – 7
Min:Very NegativeMax:Very Positive
Q07
Multiple ChoiceRequired
In the last 30 days, how often have you engaged in [behavior]? (Template note: replace bracketed behavior with your target behavior.)
- Never
- Once
- A few times
- About weekly
- Almost daily
Q08
AI Interview
Explore the relationship between this respondent's stated attitude and their actual reported behavior frequency. If their attitude score and behavior frequency seem mismatched (e.g., positive attitude but rare behavior, or vice versa), probe specifically what enabled or prevented the behavior the last time an opportunity arose. Ask for one concrete, recent example rather than a general impression, and find out what single change would most likely shift their behavior going forward.
Q09
Message
Almost done! Just a few background questions to help us understand who took part in this study. All of these are optional.
Q10
Multiple Choice
What is your age range?
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65 or older
- Prefer not to say
Q11
Multiple Choice
What is your gender?
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q12
Dropdown
What is the highest level of education you have completed?
- High school or equivalent
- Some college
- Associate degree
- Bachelor's degree
- Master's degree
- Doctoral or professional degree
- Prefer not to say
Q13
Multiple Choice
What is your current employment status?
- Employed full-time
- Employed part-time
- Self-employed
- Student
- Unemployed
- Retired
- Prefer not to say
Q14
Message
Thank you for completing this questionnaire! Your responses will be combined with others and analyzed in aggregate as part of this dissertation research. No individual answers will be shared or reported separately.
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- Includes three separate matrix batteries (attitude, norm, and intention constructs) that thesis researchers can adapt to their own theoretical model rather than a single generic scale
- Pairs a stated-attitude opinion scale and a self-reported behavior-frequency question with an AI follow-up interview step that specifically probes the gap between what respondents say and what they do
- Uses a transparent, editable AI follow-up prompt so committee members and IRB reviewers can see exactly what is being asked
- Places demographics at the end after the attitude/behavior/intention batteries, supporting clean subgroup analysis without priming effects
- Opens with a consent screen and closing debrief message, giving the skeleton the basic research-ethics structure a dissertation instrument needs
SurveySparrow
Free Likert Scale Questionnaire Template | Customizable to any likert scaleThis is a general-purpose Likert scale template rather than a construct-specific attitude-behavior-intention instrument, so researchers would need to build the norm/intention/behavior structure themselves. It's a fielding-ready form, not a methodology guide, and covers the scale-item format broadly rather than dissertation-specific research design.
What it does well
- Fielding-ready and easy to customize to any set of Likert statements
- Simple, familiar UI for straightforward agree/disagree data collection
- Free to use as a starting template
Where it falls short
- No adaptive follow-up to probe reasoning behind responses — it's a static question set
- No built-in structure separating attitude, norm, intention, and behavior constructs
- No transparent prompt methodology or automated per-response quality scoring since there's no AI layer
QuestionPro
Life attitude survey questions + sample questionnaire templateThis is a sample attitude questionnaire with example questions rather than a modular skeleton built for hypothesis-driven dissertation work; it reads more like a reference question bank than a ready instrument with consent, demographics ordering, and construct batteries built in. Useful for drawing item ideas but not structured around attitude-behavior gap analysis.
What it does well
- Provides sample attitude question wording researchers can reuse
- Backed by an established survey platform with broad question-type support
- Accessible as a free reference template
Where it falls short
- No adaptive AI interview or voice-based follow-up to explore inconsistencies between attitude and behavior
- No documented placement of demographics for subgroup-analysis hygiene
- No transparent, inspectable AI prompt logic since it's a static question list
Frequently asked questions
What questions are in the “Dissertation Attitudes and Behaviors Research Questionnaire” template?
The template includes 14 ready-to-use questions, starting with: “Thank you for taking part in this research study. This questionnaire asks about your attitudes and behaviors regarding a…” · “Before we begin, please review this brief consent statement.” · “Please indicate how much you agree or disagree with each statement about [construct name].”. The full set is previewed above, and every question is editable.
How long does this survey take to complete?
Respondents typically finish the 14 questions in about 7 minutes.
Can I customize this template?
Yes — every question, answer option, and the ordering is editable before you launch. You can add or remove questions, or ask the AI editor to rework the survey around your research goal.
Is this template free to use?
Yes. Open it in the editor and start customizing right away — no account required to try it, and the free plan covers launching your survey.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.
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