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Publication cover design

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Title:
Publication cover design its affect [i.e. effect] on readers
Creator:
Starrett, Marilyn K
Publication Date:
Language:
English
Physical Description:
v, 51 leaves : illustrations ; 29 cm +

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Subjects / Keywords:
Magazine covers ( lcsh )
Color in design ( lcsh )
Color in design ( fast )
Magazine covers ( fast )
Genre:
bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

Notes

Bibliography:
Includes bibliographical references (leaves 47-51).
General Note:
4 copies of the Fall 1993 issue of "Planning for Health" inserted in pocket.
General Note:
Submitted in partial fulfillment of the requirements for the degree, Master of Arts, Communication.
General Note:
Department of Communication
Statement of Responsibility:
by Marilyn K. Starrett.

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Source Institution:
University of Colorado Denver
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Auraria Library
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All applicable rights reserved by the source institution and holding location.
Resource Identifier:
31508781 ( OCLC )
ocm31508781
Classification:
LD1190.L48 1994m .S73 ( lcc )

Full Text
PUBLICATION COVER DESIGN:
ITS AFFECT ON READERS
by
Marilyn K. Starrett
B.A., Metropolitan State College, 1979
A thesis submitted to the
Faculty of the Graduate School of the
University of Colorado at Denver
in partial fulfillment
of the requirements for the degree of
Master of Arts
Communication
1994


(^)1994 by Marilyn K. Starrett
All rights reserved


This thesis for the Master of Arts
degree by
Marilyn K. Starrett
has been approved for the
Department of
Communication
by
Samuel Betty
Michae Monsour


Starrett, Marilyn K. (M.A., Communication)
Publication Cover Design: Its Affect on Readers
Thesis directed by Associate Professor Samuel Betty
ABSTRACT
This study examines the influence of publication cover design on readers. It
asks if the cover is remembered, if the publication is read and if it motivates any
discussion or action. To test the effect of cover design, I designed four different
covers, each with identical contents. Two covers have color photographs and two
have black and white photographs. Two covers have large photographs, magazine
format, and two have small photographs with copy beginning on the covers,
newsletter format. The publications were mailed to a random sample of 800 Kaiser
Permanente members, who were interviewed by telephone. The data show that a
large color photograph on the cover made the publication the most memorable and
the best read. Cover design did not affect discussion or action. The next task for
researchers interested in persuasiveness of printed communication is to study
behavior change as a result of message type and content for specific audiences with a
high interest in the topic, such as nutrition messages for diabetics.
IV


This abstract accurately represents the content of the candidate's thesis. I recommend
its publication.
Signed
Samuel Betty


ACKNOWLEDGEMENTS
This research was funded by a Kaiser Permanente research and development
grant. I extend a special thank you to Arne Beck, PhD, Ned Calonge, MD, Kristin
Paulson Snyder, PhD, and Linda Schulte at Kaiser Permanente and to Sam Betty,
PhD, Mike Monsour, PhD, and Craig Janes, PhD, at the University of Colorado at
Denver, for their support, advice and encouragement. Thank you also to John
Starrett.


CONTENTS
1. INTRODUCTION....................................................1
Research Question..............................................1
Background.....................................................3
Trends that Forefront the Issue................................5
Purpose, Issues, Objectives and Questions Guiding the Research.6
Definition of Basic Terms......................................8
2. LITERATURE REVIEW..............................................10
Selection Criteria and Organizational Framework for the Study.10
Survey and Review of Previous Scholarly Work..................10
Summary of Present State of Research..........................17
Questions Facing Researchers..................................19
3. METHOD.........................................................20
Type of Study and Rationale...................................20
Procedure.....................................................20
Study Hypotheses..............................................24
Definitions...................................................24
Strategy for Data Analysis....................................25
4. RESULTS........................................................26
Study Hypotheses..............................................26
Analysis Tables...............................................27
5. FINDINGS.......................................................38
Discussion ...................................................39
Alternate Procedures..........................................45
BIBLIOGRAPHY.......................................................47


CHAPTER 1
INTRODUCTION
The competition for our attention is intense. Television, radio, billboards,
bus boards, newspapers, magazines, newsletters all want our attention, as do our
families, work and school. We must be selective in giving our attention. Aside
from home, work and school, what is it that grabs our attention and holds it?
What motivates us to action?
Consider what arrives in your mail box everydaybills, direct mail
advertisements, magazines, newsletters, catalogues. How do you sort through this
myriad? If a magazine or newsletter has a colorful cover or a large photograph,
does it entice you to open it? Do the cover words grab your interest?
Chances are you don't know why you open some magazines or newsletters
right away and not others. This study examines these questions in regard to a
specific newsletter, Planning for Health.
Research Question
How does Planning for Health's cover design affect if it's remembered, if
it's read, and if it motivates any discussion or action?
A few definitions are necessary to begin to answer the research question.
Planning for Health is a 16-20 page quarterly newsletter mailed to 141,000


households that are members of Kaiser Permanente health care program in the
Denver/Boulder area. Cover design means what is on the cover of newsletters,
magazines and newspapersphotographs, color, content blurbs or headlines, and
copy. Memorability means do people recall receiving the publication in the mail
and what do they remember about the coverphotographs, color, content blurbs
or headlines, and copy. What do they remember about the rest of the issue?
Motivates means how many say they read any or all of it, did they discuss it with
anyone, and did they take action because of it.
The independent variables are cover format and color. Format is the
general composition, style or arrangement of a publication. The formats are
newsletter or magazine. A generally accepted definition of newsletter format is
that one or more stories begin on the cover and continue inside the publication. It
has small or no photographs or drawings on the cover. Traditionally it is letter
size8 1/2 x 11 inchesand resembles a newspaper in design (Arth and Ashmore
1981). A generally accepted definition of magazine format is that the cover
contains a large photograph or drawing and content teasers also called blurbs
(Reedy 1993). Both magazines and newsletter formats contain nameplates and
dates. Color is which and how many colors are used, in this case two or four
colors.
2


These definitions are general and certainly don't apply to all newsletters
and magazines. Reader's Digest, for example, has no photograph, illustration or
other graphic representation on its coverit has the table of contents. Nature
Conservancy is a magazine in format and a newsletter in content.
These are operational definitions for this study.
Background
An examination of the magazine business and publishing over the last 10
years shows that in spite of economic ups and downs, magazines are a growing
force in our economy.
Grabbing and holding our attention is big business. TV Guide was the
biggest in 1992, among magazines, with $822,132,000 in revenue {Folio 500
1993). Even the 500th magazine, Pharmacy Times, earned $4,873,000 in 1992
{Folio 500 1993). Parade magazine reached the most people with a circulation
of 36.3 million in 1992 {Folio 500 1993), followed by Modern Maturity, Reader's
Digest and TV Guide. Folio 500 lists only the top 500 consumer magazines.
These top four magazines have grown in circulation since 1985, although
growth slowed in the '90s. Many of the top 500 magazines dropped a few
percentile points in circulation between 1991 and 1992. Consumers and
advertisers were pinching their pennies in 1992.
3


"Despite [economic] doom and gloom, several major [magazine] start-ups
are in the works. Potential launches are different in that they are relying more on
circulation and less on advertising" (MacCambridge 1992, D4).
Magazines, newsletters, newspapers and other forms of graphic
communication are major, sustaining forces of our economic, political and
cultural existence. Millions of printed pieces are produced daily and millions of
wastebaskets are dumped nightly (Turnbull and Baird 1975).
That we are deluged with publications is commonly accepted, but the
number of publications, magazines especially, is debatable. "By 1970 the number
of technical and scientific journals had grown to 100,000 and this number is
expected to increase tenfold by the year 2000" (Pettersson 1989, 21).
Responsible organizations in the field have said there are 200 magazines, while
other equally responsible organizations estimate their number at more than
100,000 (Paine and Paine 1987). These estimates include magazines only.
Consider the daily newspapers, and the myriad publications we receive in the
mail by virtue of belonging to a groupSierra Club, Nature Conservancy,
Environmental Defense Fund, American Express, United Mileage Plus, societies,
professional organizations, neighborhood groups and so on.
Each of these groups' publications have a message, information, ideas they
want you to read, to remember, and perhaps to act on. Which ones accomplish
4


their objectives? How? This study examines the elements of publication covers
that are compelling to the reader.
Trends that Forefront the Issue
History is replete with legibility studies. Research has examined type
elementssize and style affect on speed of reading, distance at which various
types can be read, column length and speed of reading, recognizability of words
and letters, ease and speed of reading all capitals or all lower case letters, italics
versus roman-style letters, bold face versus text type, serif versus san serif type
style. This research shows that serif type is more legible than san serif. Since serif
type has fine lines, especially a fine cross stroke at the top or bottom of the letter,
researchers speculate the serifs help direct the eye. (This type is serif. This type
is san serif. Its letters are of equal weight and have no cross stokes.)
(Tinker 1963).
There is research on the psychological impact of pictures and color.
Presentations using visuals are more persuasive than unaided presentations and
people prefer their visuals in color (Pettersson 1989).
There are, however, almost no studies on the effect of cover design per se.
Since the cover gives the first impression of a publication, designers, editors, art
directors and circulation managers believe that cover design has a tremendous
5


impact on the publicationits image, style, memorability, if it attracts and holds
attention and if it's read. "The cover...tells the purchaser at a glance whether the
contents are frivolous or profound, polemical or reassuring, high brow or low
brow" (Morgan and Welton 1992, 21). The cover has to snare the reader and pull
him inside to the editorial (Merrill 1985). "Through the cover, the editor must
establish a sense of urgency and importance about reading particular parts of the
magazine so that the reader will open it immediately and not relegate it to the
coffee table." (Carter 1982, 58).
Purpose. Issues. Objectives and Questions Guiding the Research
The purpose of this research is to discover in a relatively controlled study
if cover design affects memorability, interest and action. Does the cover
communicate most efficiently and effectively in color or in black and white?
Does photo size matter? Does the cover take readers inside, entice them to read
the copy? If so, is the copy persuasive, does it compel the reader to action?
The objective is to research and analyze the effect of four different covers
with the same copy and photographs on randomly selected subjects. At issue are
resourcesmoney, time, environmental impactfor the production of
publications. Consumer publications are businesses. They generate revenue.
Non-profit or special interest publications are an adjunct to the business or group.
6


They are designed to convey specific messages to specific audiences. How do
we know if they are successful communication tools? Are they worth the money,
time and resources spent to produce them?
The question is how do we know if they are successful. Glamour
magazine does a subscriber survey every month to gauge reader interest and spot
trends (Gamble and Gamble 1986).
An informal survey of five publications produced by non-profit
organizations showed that only one conducted a reader survey in the past five
years. View magazine published by Group Health of Puget Sound conducted a
reader survey in 1989 (Kawaguchi 1991). CU Health Reader published by the
University of Colorado Health Sciences Center has never conducted a reader
survey (McAdams 1991), nor has EDF Letter published by the Environmental
Defense Fund (Watson 1991), nor have any of the Blue Cross Blue Shield
publications (Miller 1991), nor has the Nature Conservancy (Cheater 1991).
"Studies in Japan have shown that the ratio between 'utilized' and
'available' information has fallen from about 40 percent in 1960 to about 10
percent in 1975, so 90 percent of available information was wasted from the
senders point of view" (Pettersson 1989 22).
The questions for editors and publishers of non-profit publications are:
Do those on your mailing list remember your publication? What do they
7


remember? Do they read it, and if so, what do they read? Do they discuss the
information, and do they take any action? Do they write their congress persons,
start an exercise program, sign an organ donor card or attend lectures?
A first step to action is to grab the reader's attention. How do we know if
a publication grabs attention? What compelswords, photos, illustrations, color
or format? Much time and effort are invested in covers. Are they worth it?
Definition of Basic Terms
Newsletter: A newspaper containing news or information of interest
chiefly to a special interest group (Merriam-Webster 1964). "Newsletters convey
specific information to specific audiences with the goal of favorably influencing
that audience's perception of the organization" (Arth and Ashmore 1981, 2).
Magazine: A publication usually containing stories, articles or poems and
issued periodically (Merriam-Webster 1964). Magazines are vehicles for ideas,
and are usually issued periodically, paper bound, contain feature articles,
photographs and art (Paine and Paine 1987).
Two Color: In the print process any two colors used to print a piece. In
printing, black is considered a color, so a two color publication is often black and
another color.
8


Four Color: In the print process four colorsyellow, blue, red and black-
are the minimum necessary to duplicate what we consider full color.
Graphic Design: The lines, shapes, colors and textures combined with
words in a printed piece with the objective of communicating (Turnbull and Baird
1975).
Legibility: The ease and speed with which a printed piece is read (Tinker
1963).
Content Blurbs: The words, usually on the cover, that tell the reader
about the major and secondary articles. Their purpose is to attract the reader's
attention and interest.
Headlines: The words that tell what an article is about. Their purpose is
to attract the reader's attention and interest.
Copy: The words in an article.
9


CHAPTER 2
LITERATURE REVIEW
Selection Criteria and Organizational Framework for the Study
I examined the elements on publication coverswords, photos, drawings,
color, typeand asked: What do I want to know about these? I want to know
how these elements interact to produce memorability, interest and action, my
constructs. I cross-referenced the elements with the constructs. I began with the
broad and well-researched areas of legibility studies and narrowed to studies of
pictures in communications, to studies of the interaction of pictures, words and
color on memory and perception, to graphic design and communications, and
finally to the specifics about coverstheir purpose, design, influence and musings
on their effectiveness.
Survey and Review of Previous Scholarly Work
One of the earliest legibility studies was conducted by Anisson in Paris in
the 1790s. His results showed that garamond type style was the most readable
(Spenser 1968). Garamond is a roman-style type similar to what you see The
Denver Post and the Rocky Mountain News. Roman-style types are the most
10


commonly used today and in historya venetian-roman type was used in 1470.
This book is on display in the Library of Congress.
The important aspect of legibility is that it promotes ease of reading and
understanding. "The true economics of printing must be measured by how much
is read and understood, and not by how much is produced" (Spenser 1968, 6).
Miles Tinker, who conducted more legibility studies than anyone else, said, "The
printed page contains no meaning, but only symbols which stand for meanings"
(1963, 64). His studies showed that people prefer the type styles that are also the
most legible.
In spite of a rich history of legibility studies, designers and printers have
little knowledge about them (Spenser 1968). Spenser believes they see these
studies as a threat to their creative freedom. These studies looked at the legibility
aspects of the printed word. Other studies have examined pictures and how much
people remember about picture content.
Scientists from 1939-1981 studied just how much subjects really
remembered about picture contents. They found more time was required to
remember a picture than to merely recognize it and meaningful material is
learned more easily and remembered longer than meaningless material. Pavio
(1983) showed our memory for pictures is superior to our memory for words.
This is called the 'pictorial superiority effect.' Picture-word combination is
superior to memory for either alone (Pettersson 1989, 105).
Getting and keeping a reader's attention may be improved by using
different design variables such as color, changes in brightness, varying the
size of a particular pictorial subject. Vogt et al. (1986) showed that it is
11


undeniable that visual presentation support is persuasive. Presentations using
visual aids were 43 percent more persuasive than unaided presentations
(Pettersson 1989, 105).
Pettersson also said that people prefer visuals in color and that advertising
is more effective in color than in black and white.
If people like the content in a picture, they like it even more when the
visual is presented in color... From many experiments it is clear that people
usually prefer color in visuals. Advertising is known to be much more
effective when visuals are in color than in black and white (Pettersson 1989,
105).
"Economic hard times be damned," says Quill (1994, 50) as seven
journalism magazines change their appearance. "The recent bursts of energy
appear connected to a concern that is also turning newsrooms on their ears these
daysfinding more ways to catch readers' eyes. 'People are so rushed,' says
Terence Poltrack, editor of Presstime. He increased the use of color, sidebars,
boxes, and other graphics because 'people have so much to read, I wanted as
many possible opportunities as I could get to grab their attention'" (Quill 1994,
51).
Turnbull and Baird said the functions of color in printing are (1) to
"attract attention. Tests have shown conclusively that the number of people
noting a printed communication is increased by the use of color. (2) to produce a
moodwarm colors, red and orange, are informal and cool colors, blue and green,
are formal. (3) to develop associationschoose the right color for the topic"
12


(1975, 130). Reds are not used often for medical publications because their
association with blood is thought to be negative. "(4) to build retentioncolor has
a high memory value. (5) to create a pleasing atmospherecolor adds balance to a
graphic" (1975, 130).
Using color effectively may be trickier than Paul Klee said: "To paint
well is simply this: to put the right color in the right place" (Klee 1956, 39).
Edward Tufte wrote, "...avoiding catastrophe becomes the first principle in
bringing color to information: Above all do no harm" (1990, 39).
Spenser said in 1968 that designers and printers know little about
legibility and thus know little about effective communications. The books and
articles I read and interviews I conducted show that designers have clear and
definite opinions about the purpose of graphic designit is to communicate.
The first step to communicating in print is to engage the receiver's eye.
There is research on eye movement and scanning, the rapid survey of our
environment that precedes close examination of those details that most concern
us.
Designers study the process involved in scanning in order to make the
important parts of their message coincide with them. In designing an English
page-layout we know that the reader's eye will first encounter the middle of
the page, then move to the top left, top right, bottom right: anything in the
bottom left will be reached last (Morgan and Welton 1992, 60).
13


Once the receiver's eye is engaged, the person must find meaning in
image. "The effectiveness of a printed message is the result of a writer and a
designer expressing a common meaning" (Turnbull and Baird 1975, 4). "Find the
design approach that communicates the editorial message" (Scala 1985, 146). "A
good design is a combination of words and pictures that make the message the
editor is trying to get across really lodge in the reader's mind" (Newcomb 1985,
146).
Helping the reader remember the printed piece is a key objective in
design. "We must present words and pictures so adroitly that no effort is required
to remember them because the very deftness makes their point stick" (White
1982, 6). Turnbull and Baird said there are three basic design objectives: (1) to
attract attention, (2) to present the message so it can be easily read and
understood, and (3) to make an impression. Making an impression helps the
reader remember the information, may win the reader to the editor's point of
view, gain acceptance for the ideas or help to create an emotional response
(1975).
The communication effectiveness of the words and pictures coalesce on
the cover of publications. "How and what is displayed on your cover can (and
almost certainly will) determine whether your publication is opened now. Or
later. Or never" (Merrill 1980, 68).
14


Designers agree that the cover is one of the most important elements of a
publication.
Everyone on a publication cares aboutand worries about the cover.
That's because it is so many things to so many people: an attention-grabber
on the newsstand; an attention-seeker on a desk or on a coffee table; a
curiosity-arouser tempting one to look inside; in short, a showcase for the
product (White 1976, 1).
"Your magazine's cover is the single most important element in creating
an overall image of the magazine. A magazine cover is an ad for the magazine"
(Merrill 1980, 68). "The cover is the package. It's a marketing tool, a problem in
communication and a problem in industrial design" (Peter 1978, 44). Designers
also agree that a basic objective in cover design is consistency so readers easily
can identify the publication. This can be accomplished with the nameplate or
logo, publication size, and sometimes one special color, like National
Geographic's distinctive yellow cover or Time magazine's red border. Another
objective is recognition. "Consistency must be combined with change. The cover
must allow reader to quickly recognize that they are looking at a new and
different issue" (Peter 1978, 46). A key objective is getting the reader to take
actionto buy the publication, to open the publication, to read the publication and
perhaps to act on what was read.
Two things are important in getting a person to take actionwords and
illustrations. More attention is focused on the words on the cover than on any
other words in the magazine. Well-written blurbs are one of the surest ways
to get a reader to pick up a magazine (Peter 1978, 46).
15


"It is safe to say that the cover lines are far more important than the
illustration. It is the words that flash that signal of significance to the reader's self
interest" (White 1976, 1).
A good starting formula is a primary cover story with a single
illustration and a big blurb. Then .add a few smaller, alternate blurbs about
secondary stories within the issue. Assuming that the cover is an ad for the
magazine, give the potential reader many reasons to become an actual reader
(Merrill 1980, 71).
In spite of the importance of the cover blurbs, "when readers talk about
liking or disliking a cover, they do not mean the blurbs. They usually mean the
cover illustration" (Peter 1978, 48). Whether the cover illustration is a drawing, a
painting or a photograph depends on a multitude of variables according to most
designers. Generally the cover illustration should reflect the content. The New
Yorker is immensely successful, however, and the cover almost never reflects the
content. Generally large color photos have more impact (Merrill 1980). But if the
photograph is dull, size won't help (White 1976).
Most important is to have stories that people are interested in on the
cover. You should have a hot story that is well-presented. Check lists don't
work well. They used to say that babies, cute dogs and women sell
magazines. So you could have a cover with a woman feeding a dead baby to
a cute but snarling dog. Think it would sell? (Paul 1991, telephone interview
by author).
Probably it would. The unexpected grabs attention. It sells. Vanity Fair's
cover with pregnant, naked Demi Moore sold out at many newsstands.
16


"We occasionally encounter graphic presentations where unexpected
juxtapositions are deliberately sought. This might be referred to as graphic irony-
-a pretense of ignorance regarding the inappropriateness of an image" (Morgan
and Welton 1992, 66). The purpose of graphic irony is to overcome selective
perception that
directs our attention to those messages we know we will like, that suit our tastes,
confirm our prejudices, or excite our indignation (Morgan and Welton 1992). If
an image is unexpected, it will attract our attention and bypass our selective
perception.
Summary of Present State of Research
Almost no research exists on the effect of cover design.
There is surprisingly little research in this area which could be called
scientific. Most statistics come from newsstand sales and only a relatively
small percentage of magazines are sold on newsstands. Even for many
newsstand magazines, single copy sales represent only a portionfrequently a
small portion of their total circulation (Peter 1978, 44).
Although newsstand sales are frequently a small portion of circulation,
there is a battle for space.
The good news is, the number of [magazine] titles has risen nearly 50
percent since 1982to 3,300and so have dollar sales, to around $3.8 billion.
The bad news is, retail rack space hasn't doubled, and unit sales of all those
magazines increased only 10 percent in the same decade (Phillips 1994, 66).
17


Designer John Peter says he has served on cover committees of a number
of high circulation publications. At one they had a friendly "cover pool" in which
they'd pick the newsstand sales figure for each cover. "The circulation manager,
who took a scientific approach, won no more often the rest of us but he always
had a better explanation for losing" (1978, 44).
"There's very little reliable cover research around. While I was at Time,
the only thing we learned conclusively was that if too much of the logo is
covered, some of the people who are looking for Time on the newsstand won't be
able to find it" (Merrill 1980, 71).
I telephone interviewed four magazine designers nationwide. Two said
there must be studies and referred me to other designers, circulation managers and
magazines. Two said there are no studies on the effect of cover design. It's not a
science. There are too many variables.
It's not a science. Rolling Stone put David Bowie on two covers
presented in the same way, in the same colors. One version had lots of teasers
and one had fewer. They put the issues on newsstands at convenience stores
in small southern California towns. The one with fewer teasers sold five
percent more. The problem is you can't generalize this information. It just
gives you information about how this specific issue sells in small southern
California towns (Paul 1991, telephone interview by author).
A complete redesign helped Jazz Times. They changed from a tabloid
newspaper format to a magazine-size format with four-color covers. "Newsstands
seem to know how to categorize and display us now. More people see us, buy us
18


and subscribe now. We had 480 new subscribers in October alone. That's a
record. Magazine format really helped us" (Hale 1991, telephone interview by
author).
What little research there is has focused on newsstand sales as a gauge for
cover effectiveness.
In a battle for stronger newsstand sales, increasing numbers of
magazines are taking the 'dual cover' route, selling the same issue of the
magazine with two different cover photographs in order to gamer more
newsstand shelf space and generate word-of-mouth. Would you rather know a
smiling or glowering David Letterman? Would you be more likely to buy a
magazine featuring David Duke or one featuring Bruce Willis on its cover?
Some publications targeted toward the younger set are even finding that if
they use two different cover photos of the same teen idol on their covers,
young consumers will buy both! (Chapnick 1992, 2).
"It's wrong to point to newsstand experience and automatically apply it to
all magazines. Far and away, most magazines arrive through the mail at the home
or office" (Peter 1978, 44).
Questions Facing Researchers
Obvious questions for researchers are: Are there too many variables?
Can some of these be controlled? Is research even being tried with subscribers
instead of with newsstand sales? If consumer publications judge their success by
revenue, how do non-profit publications judge their success?
19


CHAPTER 3
METHOD
Type of Study and Rationale
I used the experimental method of research. I developed a research
questionhow does cover design affect recall, interest and actionhypotheses,
operational definitions and variables. I conducted a relatively controlled
experiment with randomly chosen subjects. I analyzed data by appropriate
statistical and mathematical rules for the existence of significant relations (Tucker
etal. 1981).
Procedure
Planning for Health is mailed quarterly to 141,000 households in the
Denver/Boulder area. To test the effect of cover design on recall, if it was read,
discussed and if there was any move toward behavior change, I designed four
different covers each with identical contents. Two covers have color photographs
and two have black and white photographs. Two covers have large photographs
magazine formatand two covers have small photographs with the story
20


beginning on the covernewsletter format. (See map pocket at back for samples
of each cover.)
Version A is a four-color magazine format. It has a four-color photograph
that dominates the cover, the content blurbs are highlighted by blue (Pantone
Matching SystemPMSnumber 279). Version B is a four-color newsletter
format. It has a photograph in four colors that takes about 1/3 of the page, the
copy is in black and the headline is in blue (PMS number 279), the story begins
on the cover and continues inside. Version C is a two-color newsletter format. It
has a black and white photograph that takes about 1/3 of the cover, the copy is
black and the headline in blue (PMS number 279), the story begins on the cover
and continues inside. Version D is a two-color magazine format. It has a black
and white photograph that dominates the cover, the content blurbs are highlighted
by blue (PMS number 279).
The photograph in all versions is of the same person in the same pose. It
is a young Vietnamese boy who has a slight smile in the black and white
photographs and no smile in the color photographs. The nameplate {Planningfor
Health) is the same for all versions. The headline or content blurbs are in blue or
highlighted in blue on all versions.
To analyze discussion and action taken by readers, the cover story topic
was one on which any adult could take actionto sign an organ donor card. The
21


stories highlighted organ recovery services, organ transplant teams and interviews
with people who have had kidney transplants. The Vietnamese boy on the cover
will need a kidney transplant in a few years. The issue contained an organ donor
card.
For this study, we printed a total of 3,200, 800 of each version, and mailed
them to randomly selected Kaiser Permanente members. The membership
mailing list is a random computer compilation of our subscribers. The average
returned-for-address-correction rate is three percent. Colorado Data Mail prints
and applies the mailing labels to Planning for Health from a computer tape we
give them that contains all of our subscribers' names and addresses. Colorado
Data Mail randomly selected 800 from the membership mailing list of 138,893,
then randomly selected another 800 from the remaining 138,093 another 800
from the remaining 137,293 and another 800 from the remaining 136,493. They
attached the labels to each version and printed a list with the names and addresses
with the appropriate version attached. They gave me the computer tape of those
in the study, so our information services department could include home
telephone numbers for the surveyors.
I worked with Kaiser Permanente's preventive medicine physician and our
market research department in developing the survey. Market research hired
Healthcare Research to conduct the survey. While Healthcare Research charges
22


$5 for each completed interview, the surveyors are experienced, work on
weekends, and will pilot surveys to fine tune them. The final survey is attached.
The draft survey was too long and we asked too many questions about organ
donation. Those surveyed commented that they felt we were pressuring them to
become organ donors. We piloted the draft survey on 20 people, five from each
version.
The survey began the first week in November 1993, about three weeks
after Planning for Health was mailed, and concluded two weeks later. They had a
list of 800 names for each version, but quit interviewing after completing 200
interviews for each version.
Of the total 800 responding, 520 (65%) were female and 275 (34.4%)
were male. The age ranges were: 131 (16.4%) were <35 (mean age 29.8), 182
(22.8%) were 35-44 (mean age 39.5), 156 (19.5%) were 45-54 (mean age 49.2),
123 (15.4%) were 55-64 (mean age 59.5), and 154 (19.3) were 65+ (mean age
72.2). (Standard deviation is included in table 1.) The youngest respondent was
age 20 and the two oldest were age 93, none of whom read any of the issue. The
youngest reader was a 22 year-old female and the oldest readers were two 88
year-olds of each sex.
This research was paid with a research grant I requested from Kaiser
Permanente's R&D Committee.
23


Study Hypotheses
HI More respondents will remember the four-color magazine format
cover than the other three versions.
H2 More respondents will read the four-color magazine format issue than
the other three versions.
H3 More respondents will discuss the four-color magazine format content
than the other three versions.
H4 More respondents who received the four-color magazine format will
move toward behavior change than those who received the other three versions.
Definitions
Constructs are memorabilitydo respondents remember receiving
Planning for Health and what do they remember, with no prompting and with
prompting; interestdoes the issue they received interest them enough to read it;
actiondoes the issue motivate them to discuss it or take action on it. The
variables are limited to fourmagazine format, newsletter format, five colors and
two colors. The two factors are color and format.
24


Strategy for Data Analysis
I compared data for each cover version and included Chi-Square and p
values. I did 4 x 2 and 4x3 factorial analyses for each constructmemorability,
interest and motivation. I employed Chi-Square as the most appropriate test since
this study consists of categorical data. The significance level is a=0.05. The non-
respondents were included in the Chi-Square tests.
25


CHAPTER 4
RESULTS
For this study I used field experimental design to examine the influence of
publication cover design on readers. I designed four publication covers, each with
identical contents. Two covers have color photographs and two have black and
white photographs. Two covers have large photographs, magazine format, and
two have small photographs, newsletter format. The publications were mailed to a
random sample of 800 people, who were then interviewed by telephone. The data
show that a large color photograph on the cover made the publication the most
memorable and the best read. Cover design did not affect discussion or action.
The study hypotheses were tested using Chi-Square and p values. The
significance level is 5%. The data analysis determined if there is a significant
difference between color and format for recall, readership, discussion and action.
The following tables show the study results.
Study Hypotheses
HI More respondents will remember the four-color magazine format
cover than the other three versions
26


H2 More respondents will read the four-color magazine format issue than
the other three versions.
H3 More respondents will discuss the four-color magazine format content
than the other three versions.
H4 More respondents who received the four-color magazine format will
move toward behavior change than those who received the other three versions.
Analysis Tables
Version A=four-color magazine format; Version B=four-color newsletter
format; Version C=black and white (two-color) newsletter format; Version
D=black and white (two-color) magazine format. (Samples are in the attached
map pocket.)
27


Table l.~Age and Gender
Version A Color/Mag Version B Color/ Newsltr Version C B&W/ Newsltr Version D B&W/Mag
Mean Age 48.3 48.9 50.4 52
(S.D.) (15.2) (14.9) (14.9) (16.1)
Males 87(43.5%) 58(29%) 68(34%) 62(31%)
Females 108(54%) 142(71%) 132(66%) 138(69%)
There were five no responses on gender for Version A, the color magazine
format.
Table 1 includes demographicsage and genderof each sample group. Those
who received the color magazine had a closer balance of males (43.5%) and
females (54%) than the other three groups. The color newsletter had the most
females (71%) and only 29% males. The black and white magazine sample had
69% females and 31% males and the black and white newsletter had 66% females
and 34% males. The mean age varied by four years from 48.3 years (color
magazine) to 52 years (black and white magazine).
28


Table 2.Unaided Recall About Specifics on the Cover
Version A Color/Mag Version B Color/ Newsltr Version C B&W/ Newsltr Version D B&W/Mag
Cover 15(7.5%) 9(4.5%) 4(2%) 4(2%)
Content 64(32%) 45(22.5%) 44(22%) 43(21.5%)
Blurbs*
Other 7(3.5%) 13(6.5%) 12(6%) 9(4.5%)
Nothing 114(57%) 133(66.5%) 140(70%) 143(71.5%)
Chi-Square 63.78, p=.001
* Content items named were categorized as organ donation, insert on
nutrition and flu shots.
Table 3.Unaided Recall About the Cover Content
Version A Version B Version C Version D
Color/Mag Color/New B&W/New B&W/Mag
Recall
Yes 86(43%) 67(33.5%) 60(28.5%) 56(28%)
No 114(57%) 133(66.5%) 140(70%) 143(71.5%)
Chi-Square 11.73, p=.008
29


Data in tables 2 and 3 support HI with 43% who recalled, without
prompting, something about the cover of the color magazine. The color
newsletter was remembered by 33.5%. The black and white versions were
remembered by 28%(magazine) and 28.5%(newsletter). The p value for color
was significant.
Table 4Unaided Recall About the Cover Photo Color
Version A Version B Version C Version D
Color/Mag Color/New B&W/New B&W/Mag
Recall
Yes 121(60.5%) 75(37.5%) 69(34.5%) 72(36%)
No 78(39%) 125(62.5%) 131(65.5%) 128(64%)
No Rsp 1(0.5%)
Chi-Square 38.07, p=.00000003
Data in table 4 support HI with 60.5% who received the color magazine version
saying they remember the color of the cover photograph. This is almost double
the number of those who received the other three versions who said they
remember the color of the cover photograph. The p value was .00000003.
30


Table 5.Unaided Recall About the Cover Photo Size
Version A Version B Version C Version D
Color/Mag Color/New B&W/New B&W/Mag
Recall
Yes 87(43.5%) 56(28%) 52(26%) 45(22.5%)
No 112(56%) 114(72%) 148(74%) 155(77.5%)
No Rsp 1(0.5%)
Chi-Square 24.34, p=.00002
Data in table 5 support HI with 43.5% who received the color magazine saying
they remember the size of the cover photograph. This is almost double the
number who received the other three versions. The p value was .00002.
Table 6.--Aided Recall About Seeing a Picture of a Child
Version A Version B Version C Version D
Color/Mag Color/New B&W/Newlt B&W/Mag
Yes 70(35%) 41(20.5%) 42(21%) 53(26.5%)
No 130(65%) 159(79.5%) 158(79%) 147(73.5%)
Chi-Square 14.25, p=.003
31


Data in table 6 show that for aided recall about the cover photograph, color
magazine format is superior, supporting HI. Of those who received the color
magazine, 35% remembered seeing a photograph of a child. The recall percents
for the other versions were in the 20s, with the black and white magazine having
the highest at 26.5%. The p value was .003.
Table 7.Aided Recall About Seeing an Insert on Eating for Good Health
Version A Version B Version C Version D
Color/Mag Color/New B&W/Newlt B&W/Mag
Yes 97(48.5%) 66(33%) 51(25.5%) 96(48%)
No 103(51.5%) 134(67%) 149(74.5%) 104(52%)
Chi-Square 32.8, p=.001
Data in table 7 support HI as the color magazine had 48.5% who remember, with
prompting, an insert on nutrition, which was listed as a cover blurb on all
versions. The black and white magazine had 48% who remember, with
prompting, the nutrition insert. The black and white newsletter had the lowest
recall, with prompting, of 25.5%. The format is significant.
32


Table 8 Aided Recall About Seeing Anything on Flu Shots
Version A Version B Version C Version D
Color/Mag Color/New B&W/New B&W/Mag
Yes 86(43%) 66(33%) 56(28%) 77(38.5%)
No 113(57%) 134(67%) 144(72%) 123(61.5%)
Chi-Square 11.14, p=.001
Data in table 8 support HI with 43% of those who received the color magazine
remembered, with prompting, information about flu shots, which was listed as a
cover blurb. The black and white magazine format had 38.5% who remembered
and the black and white newsletter had the fewest who remembered, 28%. The p
value was .001.
Table 9. How Much Would You Say You Read?
Version A Version B Version C Version D
Color/Mag Color/New B&W/New B&W/Mag
Any-Net 108(54%) 71(35.5%) 78(39%) 70(35%)
None 92(46%) 129(64.5%) 122(61%) 130(65%)
Chi-Square 33.70, p=.001
33


H2 is supported by data in table 9. Fifty-four percent read the color magazine.
All other versions had less than 39% readership. The p value was .001.
Table 10.--Did You Talk to Anyone About the Information in This Issue?
Version A Version B Version C Version D
Color/Mag Color/New B&W/Newlt B&W/Mag
Yes 21(10.5%) 17(8.5%) 15(7.5%) 13(6.5%)
No 87(47.5%) 54(27%) 60(30%) 46(23%)
No Rsp 92(46%) 129(64.5%) 125(62.5%) 141
(70.5%)
Chi-Square 0.61, p=.895
Table 10 addresses H3, if people discussed information in the publication. Data
are not significant, and thus do not support H3. However, more who received the
color magazine discussed information (10.5%), than who received the other
versions, from 8.5% for the color newsletter to 6.5% for the black and white
magazine.
No Response: If those surveyed answered yes to "seeing" anything about organ
donation, an insert on eating for good health, health education classes, or flu shots
and said they read any of the issue, the interviewer asked how much they read of
the specific articles they remembered seeing. If they said they didn't read any, the
34


interviewer skipped from question four to question 11. Therefore any article they
didn't remember seeing showed as a "no response" on questions about reading and
acting on the information. If they said they read none of the issue, all the reading
and acting questions showed as no response.
Table 11 Since You Received This Issue, Have You Given More Thought to
Organ Donation?
Version A Version B Version C Version D
Color/Mag Color/New B&W/Newlt B&W/Mag
Yes 24(12%) 27(13.5%) 19(9.5%) 14(7%)
No 83(41.5%) 43(21.5%) 56(28%) 44(22%)
No Resp 93(46.5%) 130(65%) 125(62.5%) 142(71%)
Chi-Square 6.22, p=. 101
35


Table 12.Did You Sign an Organ Donor Card Before or After Reading This
Issue?
Version A Version B Version C Version D
Color/Mag Color/New B&W/New B&W/Mag
Before 26(13%) 19(9.5%) 14(7%) 7(3.5%)
After 1(0.5%) 2(1%) 2(1%)
No 173(86.5%) 181(90.5%) 184(92%) 191
Rsp (95.5%)
Chi-Square 5.80, p=. 122
Data in tables 11 and 12 do not support H4. Data were not significant and
respondents did not move toward behavior change. While the numbers were not
significant, table 11 shows that more who received the versions with color
photographs, said they gave more thought to organ donation after receiving the
issue. This is the only case in which the color newsletter version had a higher
positive response (13.5%) than the color magazine (12%). While table 12 shows
that only five people from the 800 person sample actually signed the organ donor
card, more of those who received version A, the color magazine, had already
signed an organ donor card. This issue may have confirmed their decision.
36


In summary, Hypotheses 1 and 2 were supported by significant data in
tables 1 through 9 and Hypotheses 3 and 4 were not supported by data in tables
10 through 12.
37


CHAPTER 5
FINDINGS
This field experimental design that examines the effect of publication
cover design on recall, readership and motivation to take action indicates large
color photographs are the best at grabbing readers' attention, helping them
remember the image, and inviting them to read the content. Cover design did not
appear to affect motivation and action.
The data are significant and support HI: More respondents will remember
the four-color magazine format cover than the other three covers, and H2: More
respondents will read the four-color magazine format issue than the other three
covers. While the data are not significant for H3 (More respondents will discuss
the four-color magazine format content than the other three versions) more
respondents who received the four-color format did discuss information in that
issue than did those who received the other versions. Since neither format nor
color appear to influence behavior change in the respondents, the data do not
support H4: More respondents who received the four-color magazine format will
move toward behavior change. (See table 12.)
38


Discussion
What do these findings mean to editors whose role is to reach as many
readers as possible while controlling costs? Magazine and newsletter publishing is
a high cost item. Computer-aided design has helped reduce the time needed to
prepare copy and photographs for printing, but the costs to the editor are still
increasing. The high-tech equipment and training needed to run it have kept
design costs rising for both in-house design departments and for contract design
companies. The cost to design and prepare one 16-page Planning for Health in
1991 by Lee Reedy design, before they began using computer-aided design, was
nearly $2,000. To prepare the same size issue in 1993 with computers was
$4,000. This increase is almost $1,600 more than 5 percent inflation a year. The
Lee Reedy costs are in line with the community standard.
Printing costs continue to rise, as well. The cost of paper is about one
third of any print job. Paper costs have risen about 13 percent a year. Printers also
have purchased computers and trained prepress-press operators and strippers to
create negatives directly from computer disks they receive from the designers.
The printing plates are made from the negatives. Printing color photographs takes
more steps, more expertise and more time on the presses, therefore it costs more
than printing black and white photographs. The color cover of Planning for
Health was about one third more expensive than the black and white cover. We
39


currently print over 160,000 copies of Planning for Health, which costs about
$60,000. To print color photographs would add almost $20,000 an issue.
Editors, particularly in nonprofit organizations, must ask: "Is the color
worth the cost? How important is the information in the newsletter?" Some 55
percent of those who attend Kaiser Permanente health education classes learn
about them from Planning for Health. The Kaiser Permanente health education
classes have been shown to promote healthy habits and help people change
unhealthy ones, such as smoking, obesity and sedentary lives. The classes also are
one of the unique benefits of belonging to Kaiser Permanente, which sales people
say helps them sell the plan. This study showed that 47.5 percent of those who
received the color magazine format remembered seeing the health education
classes, while only 30.5 percent who received the black and white newsletter
format remembered seeing the health education classes. If we generalize these
statistics to our entire membership of 298,000, 141,550 would remember health
education classes if Planning for Health had a color magazine format and 90,890
would remember health education classes if Planning for Health had a black and
white newsletter format. Flu shots save lives for those at high risk for the flu. The
color magazine format had 43 percent who remembered seeing flu shot
information, the black and white newsletter format had 28 percent who
remembered seeing flu shot information. Editors, health care providers and public
40


health officials could conclude that critical printed information for high risk
populations should contain big areas of color.
A key conclusion here is that color alone is not significant, but format and
color together make a difference in grabbing readers' attention and taking them
inside to the copy. Color covers are worth the extra cost only if they have large
color photographs or graphics. Readership for the color magazine version was 54
percent, better than for any other version. The color newsletter version only had a
readership of 35.5 percent, which was below the black and white newsletter
version with 39 percent readership and similar to the black and white magazine
version with 35 percent readership. A newsletter with a small color photo is as
costly as one with a large color photo but the small color photo shows no
advantage in gaining readership over black and white large or small photographs
on the cover.
The hypotheses accurately predicted that the variables of color and
magazine format would be superior for recall and readership; however, an
unexpected result was the strength of the magazine format variable in all cases of
aided recall. Data for magazine format in both color and black and white are
significant for all aided recall questions. The black and white magazine format is
almost as effective as the color magazine format for aided recall. For example,
48.5 percent of those who received the color magazine remembered seeing an
41


insert on nutrition and 48 percent of those who received the black and white
magazine format remembered seeing it. Only 25.5 percent of those who received
the black and white newsletter remembered seeing the insert and 33 percent of
those who received the color newsletter remembered seeing it. Perhaps image size
helps aided recall almost as much as color.
If the information contained in a publication is such that the reader will
have discussions or interaction about it, such as information in weekly health
education classes, retirement fund information and prenatal information, the
editor could use a black and white magazine format as effectively as a color
magazine format and save money in production.
A possible confounding issue in this study may be the slight difference in
facial expressions in the color photograph and the black and white photograph.
The boy has a small smile in the black and white photograph and no smile in the
color photograph. It is possible that the smile in the black and white image
improved the aided recall data for the black and white magazine format? In
general, people prefer pleasant images and probably remember them better. With
no difference in facial expression in the two photographs, perhaps the color effect
would have been stronger in every instance. However, image size was significant
between the color magazine and the color newsletter format in all the aided recall
42


questions and in the readership, indicating that color magazines are more
effective than color newsletters.
Another question a researcher must ask is what was the role of the
highlight color, blue, on the respondents. Blue is a cool color and thought to be
calming and impart a formal tone to printed materials. While we asked no specific
questions about blue, we can speculate that it had more of an impact on the black
and white covers than on the color covers. As a calming color, perhaps it soothed
respondents and did little to aid with memory or prompt them to open the issue.
Would a highlight color of red, orange or yellow have been more powerful? For
editors who cannot afford the production of full color photographs, a study about
the effect of highlight colors may help in improving recall and readership.
This study is valid for Kaiser Permanente members. Their demographics
are roughly similar to the general population in age and sex distributions, but are
more middle classfewer rich and fewer poorthan the population generally.
The respondents in this study were 65 percent female and the mean age of all
respondents was 49.9 years. Our respondents include more females and are older
than the population of the Denver/Boulder area generally.
Those who received the color magazine format had a better balance of
males and females responding to the interviewers. This may indicate that more
men in this group who answered the telephone said they remembered receiving
43


the issue and answered the questions than with the other three issues. The
interviewers asked the person who answered the phone if they remembered
receiving Planning for Health, if so, they were interviewed, if not, the
interviewers asked if another household member remembered the issue and
interviewed that member. Those who received the color magazine format were
slightly younger than the other three sample groups. This may have had a
minimal effect on the improved recall and readership.
Publication content certainly influences memorability, interest and
motivation. Topics such as organ donation, living wills and advance directives are
not considered pleasant topics. Interest and motivation may be low unless the
respondent has a specific interest in these subjects. Author and documentary
producer Greg Powers said at a recent ethics seminar that they could not find a
single sponsor to underwrite the PBS documentary, "Death: The Trip of a
Lifetime." While death and taxes are inevitable, perhaps because they are, people
don't seem to want to think about them until they have to. Kaiser Permanente
readership surveys show that members want to read about nutrition, women's
health, exercise and weight control and men's health, in that order. Readers
generally don't ask for articles about organ donation, living wills and end-of-life
medical care decisions.
44


Any publication could structure a similar study for their subscribers. All
publications, consumer and non-profit, have a list of their subscribers. They
could design several covers, mail them to randomly selected subscribers and
follow up with telephone interviews. However, consumer publications probably
have a relatively good gauge of cover effectiveness with newsstand sales
statistics. A publication on the newsstand must catch the consumer's eye with its
cover. Non-profit organizations' publications that are a benefit of membership,
like Planning for Health, have no newsstand statistics. Given the production and
printing costs of these member publications, studying readership with telephone
interviews is a good investment.
Alternate Procedures
This study could be approached with focus groups first to further refine
the variables. Another procedure could be to compare the effects of cover
illustration with the effects of cover photographs.
To measure behavior change based on printed communication, one could
study the effects of mailing nutrition information to newly diagnosed diabetics
compared to mailing no information for a control group of newly diagnosed
diabetics, for example. Another study could compare the effectiveness of the
45


same information on video and in print for two audiences with a "need to know,"
such as diabetics, smokers, those with hypertension.
Health information is widely available and in many formats, such as print,
video tape, interactive video programs and CD-ROM, all of which are costly.
Studies examining which of the methods are the most effective in prompting
behavior change in various audiences are important for directing our limited
health education dollars into the most effective methods for specific audiences.
This study is a prototype of the required research on the influence of
publications' design and content on readers. Each of the confounding variables in
this study -- the two different expressions on the boy's face, the highlight color,
the content could be studied for its influence on the receiver. Segmenting
audiences demographically and analyzing their various reactions to printed
communications also is an avenue for futher research. I invite researchers to study
the interaction among communication packaging, content and receiver behavior
change. Every communication medium has only a few critical seconds to engage
the receiver and induce interaction. Researchers must continue to explore
methods of engaging the receiver and editors must continue to evaluate if those
methods are worth the cost.
46


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51


Planning for Health Survey
Hello, this is____________fioin Kaiser Porinanenlo. M.iy I speak with________? IIP AVAILABLE, CONTINUE. IE NOT, TELL IIIM/LIER
THAT YOU WILL CALL BACK AT ANOTHER TIME.I
Is lliis_____? My name is______________and I am calling for Kaiser Permanente. I'd like lo ask you a few questions about our Planning for
Health publication that is sent to all members. This is a quarterly new magazine with stories about new developments at Kaiser Permancnte attd
medical care.
fIF NOT ABLE TO COMPLETE SURVEY NOW, ASK WHEN A GOOD TIME TO RE-SCHEDULE WOULD BE AND CALL BACK AT THAT TIME.I
1. First, have or has anyone in your household received a copy of Planning for Health within the past two or three weeks?
YES CONTINUE
NO > These were mailed out recently and if we have your address correct, yoit should he receiving yours soon. If it doesn't come and you
are interested in receiving a copy, call 344-7500. I hank you for you lime. | TERMINATE AND TALLYI
1 2 3 4 5 G 7 0 9 10 11 12 13 14 15 16 17 18 19 20
1a. Did you or did anyone else in your household read it or look through it?
1 YES, RESPONDENT Continue
2 YES, OTHER HOUSEHOLD MEMBER Ask lo speak lo that person
3 NO, NO ONE LOOKED AT IT Continue


UNAIDED RECALL
AIDED RECALL
USAGE
2. Without looking at the issue, what can you
tell me about it? (CHECK ALL THAT APPLY,
DO NOT PROMPT]
COVER
1 Cover Photo child/boy
2 Cover Photo color
3 Cover Photo black & white
4 Cover Photo -- other
> CONTENT
5 Stories about organ donation (kidney,
eye)
6 Story/insert about food/nutrition
7 Story about flu shots/clinics
8 Story about health Education/
classes/seminars
9 Other stories_____________________
OTHER
10 ______________________________
99 Nolhing/Can't Remember
3. Do you remember seeing [READ LIST.
ROTATE BEGINNING WITH V." DO NOT
READ ITEMS MENTIONED IN Q2 ]
YES NO
A picture of a child on the cover? 1 2
Anything about organ donation? 1 2
An insert about eating for
good health? 1 2
A listing of education classes? 1 2
Anything about flu shots? 1 2
4. How much of this quarter's Ilanningfor
11 cal ih would you say you read?
1 MOST OF IT
2 ABOUT HALF OF IT
3 2 OR 3 ARTICLES
4 ONLY ONE ARTICLE
5 Didn't Read Any Of It- SkiptoQII
5. How much of the ______did you read?
(ASK FOR EACH ITEM CHECKED ON THE
LEFT]
SCALE
1 = Read it all; 2 = Read most; 3 = Read some;
4 = Read none; 5 = Don't Remember.
Organ donation:
Family discussion article about
organ donation?
The "Questions and Answers article
about organ donation?
The article on corneal eye transplants?
The article that discussed people who
had kidney transplants?
Small booklet on nutrition?
Health education schedule?
Flu shot stoiy?


I
t
6. Did you talk to anyone about the information in this issue of Planning for Health?
1 YES CONTINUE
2 NO SKIP TO QUESTION 8
7. What was it in this Planning for Health that you talked about?
1 Organ Donation
2 Cover Photo/Child/Boy
3 Nutrition Booklet
4 Seminars/Classes
5 Other ______________________________________________________________________________________
8. Since you received this issue of Planning for Health, have yorr given more thought to organ donation?
1 YES
2 NO
9. Have you signed an organ donor card, or the back of your driver's license indicating that you want to be an organ donor?
1 YES- CONTINUE
l £J..,, } SKIP TO QUESTION 11
3 Don t Know I
10. Did you sign it before or after you read this Planning for Health?
1 BEFORE
2 AFTER
11. Several different versions of this quarter's Planningfor Health were sent out. If you think just about llm photograph on the front cover, do you remomber if it was in
color or in black and white?
1 COLOR
2 BLACK & WHITE
3 Don't Remember
12. What about the size of the picture, do you remember if it covered more than half of the page or less than half of the page?
1 MORE THAN HALF
2 LESS THAN HALF
3 Don't Remember
13. And the last question I have for you today is if you could tell me your age?_
14. Respondent Name: ____________________________ Phone Number:_____________________________________
Member ID:___________________________________ Planning For Health Copy Received: A B C D
Sex:________ Interviewer:________________________________________


Anthony Pham, age 9, has been on dialysis since last March.


KAISER PERMANENTE
P L
L T H
IT'S WORTH A
FAMILY DISCUSSION
Six lives were saved by one organ
donor last May at University Hospi-
tal. Four surgical teams, almost
simultaneously, transplanted a heart,
two single lungs and a liver,
followed by two kidney transplants
that evening.
Through organ and tissue dona-
tion, a tragic death can be a new
beginning for others.
Most often the donor family
says, At least we gave someone a
chance, says Sue Dunn, RN,
assistant director of Colorado
Organ Recovery Systems. It
makes something good come from
something bad.
Colorado Organ Recovery Sys-
tems (CORS) helps make transplants
possible. It is a nonprofit organiza-
tion designated by the federal
government to recover organs in all
of Colorado and most of Wyoming.
They are one of 69 organ recovery
organizations nationwide, each with
a specific region. This eliminates
competition.
We were established to increase
organ donation in Colorado and
Wyoming. We recover solid
organskidneys, livers, hearts,
lungs and pancreases, explains Jim
Springer, CORS director. We work
closely with the eye banks and Mile
High Transplant Bank, who recovers
tissue and bone.
IN THIS ISSUE
Organ Donation is the Gift of Life Page 2 Eating for Good
Health and Good Taste Insert Booklet Fight Flu Back Page


Anthony Pham, age 9, has been on dialysis since last March.
1*1.
KAISER PERMANENTE
L T H


KAISER PERMANENTE
P L
L
T H
3
IT'S WORTH A
FAMILY DISCUSSION
Six lives were saved by one organ
donor last May at University Hospi-
tal. Four surgical teams, almost
simultaneously, transplanted a heart,
two single lungs and a liver,
followed by two kidney transplants
that evening.
Through organ and tissue dona-
tion, a tragic death can be a new
beginning for others.
"Most often the donor family
says, At least we gave someone a
chance,' says Sue Dunn, RN,
assistant director of Colorado
Organ Recovery Systems. It
makes something good come from
something bad.
Colorado Organ Recovery Sys-
tems (CORS) helps make transplants
possible. It is a nonprofit organiza-
tion designated by the federal
government to recover organs in all
of Colorado and most of Wyoming.
They are one of 69 organ recovery
organizations nationwide, each with
a specific region. This eliminates
competition.
We were established to increase
organ donation in Colorado and
Wyoming. We recover solid
organskidneys, livers, hearts,
lungs and pancreases, explains Jim
Springer, CORS director. We work
closely with the eye banks and Mile
High Transplant Bank, who recovers
tissue and bone.
IN THIS ISSUE
Organ Donation is the Gift of Life Page 2 Eating for Good
Health and Good Taste Insen Booklet Fight Flu Back Page