THE RECEPTION or HOSPITAL puaucm
AMONG FORMER HOSPITAL PATEENTS

Thesis for H19 Dagroo 0f M. A.
MICHIGAN STATE UNIVERSiTY

James R. Dove
1959

 

THESIS

 
    
 

a,
LIBRA R Y
Michigan State

‘1 University I

THE RECEPTION OF HOSPITAL PUBLICITY
AMONG FORMER HOSPITAL PATIENTS

by

James R. Dove

AN ABSTRACT

Submitted to the College of Science and Arts

of Michigan State university of Agriculture

and Applied Science in partial fulfillment
of the requirements for the degree of

MASTER OF ARTS

Department of Sociology and Anthropology
1959

Approved

 

 

/

JAMES R. DOVE ABSTRACT

Because of a belief that the local community is not
understanding or sympathetic with local hospital problems,
the hospital administrator attempted to reach the members of
his community with information about the hospital with mass
communications. This having failed, he then concluded that
mass communications used exclusively, without public re-
lations practices within the hospital, were ineffective.

The hospital administrator then became “public re-
lations minded" and sought to promote public relations within
the hospital through the application of “public relations
practices.“ Once this was accomplished he felt that mass
communications would be effective; whereas, before they wer-
not. This is based on the belief that the reception of
hospital publicity is dependent upon previous experiences
with the hospital, and the assumption is made that “former
hospital patients“ will be attentive to hospital publicity;
whereas, “non-former hospital patients” will remain in-
attentive.

This position is not too far removed from the concept
of the unification and consensus producing powers extended
to mass communications by such sociologists as Louis Wirth
and Herbert Blumer. They are similar in that both rely upon
the "common experience“ which is believed to occur in exposure
to a piece of communication. The hospital administrator
deviates from this belief to the extent that hospital ex-
perience is believed to provide a common experience; and mass

communications then reinforce the pre-existing favorable

disposition toward communications favoring the hospital. only

ABSTRACT

among former hospital patients.

Numerous researchers have produced findings which would
contest the beliefs of the public relations minded hospital
administrator. They have shown the reception of public af-
fairs publicity, such as is hospital publicity, to be associ-
ated with socio-economic factors and that reception increases
in the direction of higher status. This framework has pro—
vided a basis for testing the following general hypothesis.
“Among former hospital patients, the reception of hospital
publicity will be associated with socio-economic status.”
This hypothesis is tested by comparing the reception of
hospital publicity to the following four measures of socio-
economic status: Occupation, income, education, and organi-
zation membership.

A random sample of one hundred former hospital patients,
selected from the admittance records of the two major general
service hospitals in Jackson, Michigan, were interviewed.
Information was recorded relevant to their former hospital
experience, their reception of hospital publicity, and their
socio-economic status. Scores were then obtained for the
informant's reception of hospital publicity and the four mea-
sures of socio-economic status were ranked.

Chi-square tests for which p s .05 revealed that the
reception of heapital publicity was associated with occupation,
education,and organization membership, but not with income.
However, observation of the data revealed that in all four

measures of socio-economic status the reception of hospital

ABSTRACT

publicity tended to increase in the direction of higher status.
Further, chi-square tests failed to indicate any association
between former hospital experience and reception of hospital
publicity.

The general replication of other research findings
provided by this study tend to discourage both the belief that
mass communications provide a unifying force and consensus
producing agent and the belief that hospital experience
influences the reception of hospital publicity. It does indi-
cate that the reception of hospital publicity, as a form of
public affairs publicity, is associated with socio-economic

factors.

THE RECEPTION OF HOSPITAL PUBLICITY
AMONG FORMER HOSPITAL PATIENTS

by

James R. Dove

A THESIS

Submitted to the College of Science and Arts

of Michigan State University of Agriculture

and Applied Science in partial fulfillment
of the requirements for the degree of

MASTER OF ARTS

Department of Sociology and Anthropology
1959

ACKNOWLEDGMENTS

I wish to acknowledge Dr. Charles R. Hoffer for his
initial stimulation of interest in the general field of
hospital research. Gratitude is also extented to Dr. Jay W.
Artis who, in acting as my thesis advisor, provided me with
constant support and supervision throughout the study.
Appreciation is extended to the many graduate students
whose interest and aid was of great value in the completing
of this thesis.

Gratitude is also extended to Mr. Thomas Deming for
his assistance in the collection of the data and finally, to

my wife, Barbara, for her careful reading of the thesis.

TABLE OF CONTENTS

Page

LIST OF TABLES AND FIGURES ....... ................ ..... 1
Chapter

I. INTRODUCTION

Statement of the Problem ...................... 1

Hospital Public Relations OOOCODCOIIOOIOOOOOIOO 5

Recognition of a Need for Public Relations .. 5

Definitions of Public Relations ............. 10

The Hospital Administrator's Position on
P‘lblic Relations .0.000000IOOODOOOOUOOOO... 12

Implicit Assumptions in the Hospital Adminis-
trator's View of Public Relations Indicating
Agrement with the Concept of Achieving Con-
census Within a Mass Society Through Applying
Mass Communications ......................... 18
Mass Society ......................... ...... 18
Unification of the Mass Society by Mass

Communications ............................ 20
The Relation of Hospital Public Relations to

the Concept of Unification of the Mass

Society by Mass Communications ............ 28

Mass Communications Research Findings ......... 33
Public Relations and Social Science ......... 39
Fallacy of the Position that Mass Media

have Unification Powers, and of the
Position of Hospital Administrators Re-
garding Mass Communications ............... #0

Conditions Necessary for the Study of Reception
of Hospital Publicity ....................... #1
Conditions Under Which this Study was Con-
ducted ........... ............ . ....... ..... 42

Statement of Hypotheses ............. ......... . #5
II. METHODS

Hospital Public Relations and Publicity Survey. #7
Hospital Administrators ..................... h?

Chapter Page

Hospital Women's Auxiliary

Representatives ............... .......... .. H8
Follow-Up Procedure .................. ...... . 48
Survey of Reception of Hospital Publicity ..... 50
The Sample ......... ......................... 50
Selection of the Sample ........ ........ ..... 52
Questionnaire Design ........ .. ..... ........ 5h
Pre—Test of the Questionnaire . ............. . 56

Characteristics of the Sample ................. 57

Analysis of the Data ....... .............. ..... 63
Scoring of Publicity Reception ....... ...... . 63
Socio-Economic Status Indices ........ ..... .. 65
Testing of the Hypotheses ........... ....... . 68

III. FINDINGS
Test of the Hypotheses ... ......... ..... ...... . b9
OtherFindlngfi eeeeeeeeeeoeeeeeeeeeeeeeeeeeeeee 73
Reception and Increasing Socio-Economic
Statue ......OOOOOOOOOOIIOIOOOOO... .00... 73
Reception and Former Hospital Experience .... 75
Summary of the Findings ........ ............... 77
IV. CONCLUSIONS

Conclusions .......... .......... . ......... ..... 79
Implications ........ ...... .............. ..... . 85
Limitations of the Study ...................... 88

Suggestions for Further Research .............. 9l

BIBLIOGRAPHY scene-eeeeeooeeeeeeeoeoo

APPENDIX... ........................ 97

Questionnaire for Reception of Hospital Publicity
Survey.

TABLE
I.

II.

III.

IV.

VI.
VII.
VIII.

IX.
X.
XI.
XII.
XIII.

XIV.

Figure

1.

Providers and Informants ..

LIST OF TABLES AND FIGURES

Difference Between Rejected and Replaced
Informants by Age, Sex and Residence ...........

Distribution of Occupations by Chief Providers
and Informants . ............ ....................

Distribution of Educational Achievement by Chief

Distribution of Incomes of Family or Household
in 1957 .. ................................... ...

Distribution of Hospital Publicity Reception
Scores ...................................

Distribution of Chief Providers Occupations ....
Distribution of Informants Educational Level ...

Distribution of Informants Participation. in
Local Organizations ..... ........... . . .....

Distribution of Family or Household Incomes ....

The Reception of Hospital Publicity bycbcupation

The Reception of Hospital Publicity by Income ..

The Reception of Hospital Publicity by Education
The Reception of Hospital Publicity by Number
of Organizations ....

Results of Chi-Square Tests of Association
Between the Reception of Hospital Publicity
and Measures of Hospital Experience ............

Age - Sex Distribution of the Sample ...........

PAGE

59

61

62

63

65
66

67

67
68
69
7o
71

76

60

CHAPTER I

INTRODUCTION
Statement 9; the Problem

In recent years many of our nation's hospitals have
become inadequate in providing the services and accommo-
dations for which a hospital is held to be responsible, due
to increasing patient loads and out-moded equipment. In
order to remedy this situation, the hospital administrator
has called for the financial support of the members of his
community to aid in modernizing and making more efficient
the community's hospital. He has attempted to make known
the needs of the hospital by publicizing them through the
various means of communication, chiefly the press and the
radio. In a great number of cases, the members of the
community have not responded favorably to the administrator's
plea for funds. This, the administrator has interpreted, is
evidence of a lack of community understanding and good will
toward the hospital.

In order to deveIOp community understanding and good
will, the hospital administrator has called upon the services
of the public relations man. In working to develop com-
munity understanding and good will, the public relations man
has brought to the hospital an idea which closely resembles

the concept that unification and consensus can be achieved

1

by exposing all members of a community to mass communications.
This concept of unification and consensus is one which is
vigorously supported by such sociologists as Louis Wirth and
Herbert Blumer. .They would contend that a heterogeneous

and disorganized society can be unified and concensus within
it developed through the application of mass communications.
In the context of hospital public relations, this concept is
seen to be represented by the notion that community support
and understanding may be solicited by exposing the members
of the community to publicity which promotes the hospital's
cause.

The hospital administrator, having previously experi-
enced frustration in attempting to reach the community
members with the exclusive use of mass communications, has
been more inclined to apply ”public relations practices" by
becoming more concerned with the types of experiences the
patient is exposed to while in the hospital. A conscientious
attempt is made to provide service and care for the patient
that,it is felt, will incline the patient to be favorably
impressed with the hospital. Thus, the hospital adminis-
trator's response to public relations has been to place the
emphasis on providing experiences for the patient which are
believed to be designed to promote an understanding attitude
toward the hospital.

Once this has been accomplished, the hospital adminis-
trator is then willing to indulge in the intensive use of

mass media in order to obtain the financial support of the

community. This is based on the premise that if the patient
has experienced Ipublic relations practices“ within the
hospital, his understanding attitude will incline him to be
receptive to mass communicationswhich promote the hospital's
needs, rather than reject such communications, as was felt
to be the case, prior to any attempt to apply “public re-
lations practices' in the hospital.

There are a number of assumptions made tacitly by the
hospital administrator in his public relations scheme, which,
when isolated, would provide a number of research appor-
tunities. The first and most basic of these assumptions
is that by widely distributing a piece of communication
throughout a community, all members of the community will
actually receive the communication. That is, by potentially
exposing all members of the community to publicity distri-
buted by mass communications, all of those who have been ex-
posed will receive the publicity. Another basic assumption
of the public relations minded hospital administrator is
that the community is composed of two classes of peOple,
namely, I'former hospital patients“ and “non-former hospital
patients”. This assumption is seen to be reflected by the
further assumption that of all those who have received a
piece of hospital publicity, those persons who are former
hospital patients will be more highly receptive to the
hospital's position than those who are not former hospital
patients. This would lead to still a further assumption

that of the two classes of people composing the community,

those who are former hospital patients, in being favorably
predisposed to hospital publicity as a result of their hospital
experiences, would exhibit a greater degree of reception of
hospital publicity than those persons who are not former
hospital patients. Likewise, it would be assumed that those
former hospital patients having greater exposure to the
hospital would exhibit greater reception than those former
hospital patients with less exposure to the hospital. The
final tacit assumption of the public relations minded hospi-
tal administrator would be that the two classes of people
comprising the community. would exhibit no intra—class
characteristics such as differential age, sex, occupation,
education, etc. which would account for the extent of recep-
tion of hospital publicity.

There is an abundance of research findings in the field
of mass communications which would cast serious doubt on
these assumptions of the hospital administrator. mmerous
studies have shown that, first, the reception of any publi-
city of a public affairs nature, as some hospital publicity
would be, is relatively low. Likewise, it has been demon-
strated in mass communications research that the factors
which account for the reception of public affairs publicity
are social characteristic factors, such as age, sex, occu-
pation, education, etc., and, further, that the extent of
such reception is positively correlated with increasing
socio-economic status.

It is the purpose of this study to examine the public

relations minded hospital administrator's assumption that the
reception of hospital publicity is associated only with the
individual's experience as a hospital patient, to the ex—
clusion of other factors. For the purpose of this study,

the extent of reception of hospital publicity among former
hospital patients will be measured in terms of social
characteristic factors as indices of socio-economic status.
An attempt will be made to show an association between the
reception of hospital publicity and socio-economic status

among a selected sample of former hospital patients.

HOspital Public Relgtions

Recognition _o__f_ 5 had for Public Relgtiong
The hospital, as a public service institution, has met

with two particularly outstanding conditions which have caused
considerably more attention to be focused upon it in recent
years. First, an ever increasing papulation is providing an
ever increasing public which demands attention and care in

the hospital. The average daily census of hospital in-
patients has grown from 830,098 in 193“, to l,3h2,508 in
195“.1 In proportion to the respective total populations of
these two years, the increase in the average daily census
represents an increase in hospital admissions of 187$ in
general and special hospitals.2 Second, a continuously in-

creasing amount of technical knowledge is being accumulated

__.A_—

1Dr Louis Block ~30 -
. , spital Trends, Hospital Topics
(Chicago), 1956, p.31.

22-351.. p. 39.

which is increasing the number of services for which the
hospital has become responsible. The net result of these two
conditions is that a great number of our present hospitals
are no longer adequate to provide for the high caliber of
professional medical service which is expected of them.

Many hospitals are being pressed for bed space, storage space
and equipment.

In many cases, when the hospital administrator realized
that his hospital was falling below the standard of medical
care which he felt his hospital should provide, he sought to
remedy the situation by providing more space and facilities.
This generally requires funds which the hospital does not
ordinarily have and, thus, expansion and development of the
hospital depends on securing the aid of the members of the
local community. The administrator has depended upon a be-
lief that the members of the community would be willing to
provide for the continuous growth of the hospital so that it
could provide satisfactory services. Such a belief is based
on the following concept of the place of the hospital in
relation to the community:

The modern hospital represents the community's ef-

forts to bring together the various professional

skills required in modern cars and to place at their

disposal the highly trained technical personnel and

expensive equipment upon which that care is increas-
ingly dependent. The community is willing to pro-

vide the funds because it believes that this is the

only way it can secure complete and coordinated

medical care. The community realizes that the

march of medicine has long since out-stripped the

contents of the doctor's black bag and the facilities

of his office. For this reason the members of the

community have been willing to pool their resources
in order to obtain the medical services that the

individual physician could no longer provide, and

in order to efficiently utilize all the professional

skills which now make up medical cars.3

This concept of the place of the hospital in the life of
the community impute a great deal of rationality and under-
standing to the public of the community. It implies that
the public would be ever ready to continue to “pool their
resources in order to obtain the medical services" which are
necessary for adequate hospital care. It is, perhaps, due
to this concept that, in a great many instances in which the
hospital administrator has called upon the financial support
of the members of his community and been refused their sup-
port, he has become aware of what he considered to be a lack
of community understanding and good will toward the hospital.

A survey of articles in the Journals and publications
of both state and national hospital organisations will reveal
a large number of articles devoted to Just this type of
problem. One writer, who reported meeting high resistance
and antagonism to a local hospital fund raising campaign,
claimed that the board of trustees attempted to determine the
source of the resistance.

....they discovered how little known the hospital

was to the general public. We found the public's

indifference to the hospital and its ignorancg of

the hospital's functions almost unbelievable.

Thus, the hospital administrator came to learn that the

sympathies of the public he had been attempting to serve have

 

7 *

3Ray E. Brown, “Hospital Professional Relations.I
Hogpitals, January 1, 1957, p.32.

"Victor W. Knouth, “Low Pressure — High Results,“
Hospitals, October 16, 1956, p. bl.

not always been what he expected. Further, the hospital
administrator came to learn that the hospital could not exist
apart from the consent and support of the community. In a
Journal written for hospital trustees, this statement of
awareness was made: “The hospitals you serve are peculiarly
dependant upon the beliefs and cpinions of your communities."5
Still another type of incident has sometimes been the
instrument which brought about recognition of a felt need for
better community understanding and good will toward the
hospital. A sudden rash of adverse newspaper publicity,
touched off by an incident involving the death of a child due
to hospital policy of refusing welfare cases, was reported in
one article appearing in an American Hospital Association's
publication. The writer claimed that it took this kind of
incident to begin an organized effort to develop better
public relations for the hospitals in that area. He claimed
that the newspapers were writing for a public which they knew
to be hostile to the local hospitals, a situation which would
not have existed had the hospital administrators in the area
done a good Job of educating the public.6 In this case, the
blame for the hostile attitude of the public was laid to a
poor Job of education, a poor Job of developing better under—

standing of the hospitals.

 

5Kennerly Woody, “Telling is the Key to Belling,'I
Trustee, December 12, 1957. p. 7.

6Delbert L. Price and David Kinzer, “Cooperation is
the Key of New Chicago Hospital - Press Code, Hospitals,
February 1, 1957. p. 29.

Another writer, in attempting to show the importance of
public understanding,made the following comment:

Too often hospitals tend to overlook this human

tendency to criticise what is not well understood.

To bring about better understanding is certainly

one of the fundamental objectives of any public

relations program.

Thus, the hospital administrator has been impressed with
what he feels to be the necessity of having an understanding
public and he has been impressed by the apparent fact that
quite often he does not have much public understanding of his
hospital. He has realized, as one writer put it, that:
”...communities seem to expect so much (from the hospital),
but often give so little in return."8

The Journals published by the various hospital organi-
zations have taken up the crusade to develop more and better
public understanding of the hospital. The chief method by
which this obJective is felt to be obtained is by the practice
of public relations. Rarely is a Journal published which
does not contain some article advancing the techniques and
methods which are felt to be effective in securing a
sympathetic and understanding public. Frequently, articles
are submitted by hospital administrators or members of hospi-
tal boards of directors, in which they explain either successes
or failures with various public relations techniques which

they have encountered. None ever suggest that public re-

lations are unnecessary -- rather, many unpleasant tasks are

 

7Allen H. Earth and Thomas D. Griffiths, “You - The
Ambassador,“ Hospitals, August I, 1958, p. 40.

8Kennerly Woody, Qp.gi3,, p. 7.

10
Justified only because of their “public relations value“.

Definitions g; Public Relations

An exact definition of what public relations are is
never outwardly discussed in Journal articles which discuss
public relations practices. Rather, it would appear that
public relations is something that everybody knows about;
and a tacit agreement seems to prevail which would indicate
that it is unnecessary to ponder academic questions about its
nature. In order to determine what public relations refer to,
it is generally neceggafiy to leave the specific contextual
material written about public relations and seek definitions
from more generalized sources.

Various writers have offered the following definitions
of public relations.

A public relations program is a conscious, sincere,

directed endeavor to create and strengthen contacts

which contribute to the development of mutual under-

standin , good will and respect betgeen an insti-

tution ior business and its public.

Public relations is ... the total effect of the

actions of all of the peeple who are associated with

your hospital on all the people who come in contact

with your hospital. 0

Public relations involves applying the art of mass

communication to influence public Opinion so that

some positive action is taken by the public involved.11

9Alden B. Mills, Hospital Public Relations, (Chicago:
Physician Record Company, 1939). P- 3- ‘

10Douglas Mueller, ”The Substance of a Public Relations
Program,‘ Trustee, February, 1958, p. 1.

11Charles S. Steinberg, The Mass Communicatggg: EEELlE
Qpinion, Public Relations, and Mass media,*?New Yerk: Harper
and Hrothers, 1958), p. 55.

11

The act of communicating, in a public relations
sense, involves the relaying or transmitting of a
sign or symbol -- verbal, written or pictorial --
from a specific source to a specific audience or
receiver, by means of any one, or all, of the
several media that act as channels for the trans-
mission of the symbols -- newspaper, magazines,
books, radio, television, motion pictures, or
direct speech -- for the express purpose of in-
fluencing the opinion and actions of thg receiving
individual or group, i. e. the public.

The public relations man serves as a useful middleman
or catalyst between management and the public, inter—
preting each to the other. The mass media are the
avenues of intercommunication.

The basic media through which and within which public
relations techniques Operate are the press, radio,
television, motion picture, magazine and book. Re-
lated areas in which public relations techniques

are applied include direct-mail, promotion, brochures,
posters, display cards, and other written and graphic
presentations. Thus, public relations, as an umbrella
title, embraces or covers the areas of advertising,
publicity, promotion, and exploitation.14

An attempt to explain the conditions under which public
relations arose helps to determine the nature of public re—
lations.

... as it became harder for people with different
backgrounds to understand and know about each other,
the first necessity was for one group to tell others
about itself. It (public relations) also tells the
group what others think of it; it helps the group
determine what it must do to get the good will of
others; it plans ways and means of winning that good
will; and it carries on activities designed to win

 

 

1t.1

121b1d., p. 22.
13%.! pt 70
1“Ibid” p. 117

15Ph111p Lesly, “Exactly What is Public Relations,“
Public Relations Handbook, Edited by Philip Lesly, (lbw Ybrk:
Prentice-Hall, 1950), pp. “—5.

spirit 1141

12

It is evident from these eXplanations and definitions
of public relations that, basically, public relations is a
term attached to the practice of applying mass media for the
purpose of obtaining the understanding and good will of some
designated group. In this respect, it does not appear to be

too far removed from prOpaganda.

The Hospital Administrator's Positigg 23 Public Rela-iggg

 

There appears to be a general feeling among writers of
hospital public relations articles, that hospital public
relations is essentially a staff or hospital employee problem.
Statements such as the following tend to bear this out:

Good public relations begins internally with the
training of employees to provide good service and
with the education of employees in good public
relations practices. 6

Employees are a hospital‘s good will ambassadors
and should be well informed public relations repre-
sentatives.17

Sell them (hospital employees) on the idea that the
way they conduct themselves is the bedrock of
hospital public relations.18

Hbspital staffs and personnel, its trustees and
auxiliary members reach into all parts of the
community -— into homes, into larger organizations
and assemblies. If they have been given the facts
about their hospital: if they can answer questions
about its facilities, its practices. (sic) If

they can be counted on to carry their hospital's
story across the dinner tables; the bridge tables

and the back fences of their town -— then hospitals19
won‘t have much worrying about community relations.

 

_.“--_

 

“hwm ~o---- ‘ Q—“_

h 16Allen B. Barth and Thomas D. Griffiths, 92, 2;£..
p. 0.

17Anthony J. Borowski, “Public Relations Check-List for
Administrators,” Hospitalg, February 1, 1958, p. 43.

18Delbert L. Price ani David Kinser,_Qp. gi£.. p. 32.
19Kennerly Woody, 92, gi§.. p. 9.

13

One writer of hospital public relations, a hospital
trustee, listed the various people associated with hospitals,
in the order of their importance from a public relations
standpoint, as he conceived of it.

First on the list of peOple to be won as friends

are, I think, the people who are closest to it:

its own employees. Employees are the most im-

portant single channel of communication with the

gugiigoa hospital is trying to win over to its

mmerous other articles express the same general idea,
that public relations is primarily an internal hospital
affair, but explain more specifically some of the different
areas of hospital Operation where individual employees could
promote public relations. Members of various different
hospital departments within local hospital organization have
contributed public relations articles to the hospital Journals,
many claiming that their own department‘s services are the
basic starting point for hospital public relations programs.
A hospital dietitian wrote that the service of quality food
is the key to good hospital public relations.21

Another area of hospital operation that has received
attention from the public relations position is the admitting
.and billing department. A writer on this subject maintained
that:

Patient-hospital relations will be greatly improved

if the hospital makes every effort to make the
patient's admission and payment of bills as easy and

 

 

 

20Douglas Mueller, 92, g_§., p. 3.

21Fern W. Gleiser, “We Help Train Dietitians to be
Managers,I Hospitals, May 1, 1958, p. 76.

 

1h

as pleasant as possible for him.22

Another writer on the same subject claimed that:

The public and even the members of the voluntary

hospital system frequently do not understand the

nature of hospital charges nor how they are set.

This situation has created some of the hospital's
most serious problems, such as: pggr patient re-
lations ... poor public relations.

On the subject of admitting practices, this comment was
noted:

. the routine interview can give the admitting
personnel more time to spend on the public relations
aspect of admitting -- a vital factor to an insti-
tution that is always 'in the pubkic eye', and in
need of constant public support.2

Other writers seek to encourage the hospital administrator
to make greater use of his hospital's women's auxiliary and
other voluntary organizations because of their public re—
lations value.
A strongly united and well-informed auxiliary is a
potent factor in maintaining the highest quality
of community relations. It is a significant aid to
adminégtrators in establishing prOper public senti-
ment.
... as the hospital auxiliary may become the voice
of the hospital in the community, its ggportunities
for influencing public attitude grows.

Activities of the women's auxiliary are a contributing

 

- --- M ~~ ‘-

22s. w. Walsh, “Let the Patient Know what He's Paying
For,“ Hbspitals, April 16, 1957, p. 52.

 

238. C. Laetz, 'Give the Public a Package They Under-
stand,“ Hospitals, September 1, 1957. p. #8

2“Harry T. Haver and John F. Lateham, “Roll Out the Red
Carpet,” Eggpitals, November 16, 1956, p. 4#.

25Anthony J. Borewski,_gp. gi£., p. #3.

26Kenneth Williamson, “The Hbspital and Government,“
Hospitals, April 16, 1957. p. #6.

15

factor in aha creation of good will in the

community.

The same general emphasis on public relations as being
essentially an internal hospital affair involving primarily
the staff was indicated further in a tendency to underplay
the importance of the various mass media as effective instru-
ments in promoting public understanding and good will toward
the hospital. The Journal writer previously referred to who
ranked the importance of various public relations techniques,
not only placed the behavior of the employees at the top of
the list, but relegated general publicity methods to the
bottom of the list. He maintained that:

Compared to these primary channels of communication

to the public -- the employees, the patients and

visitors, and others associated with the hospital's

work -- the uggal publicity channels are not nearly

so important. '

He does, however, feel that publicity methods may have
some value after good public relations have been established
within the hospital; but the emphasis should always remain
on the side of the employees.

Another writer expressed the view that it was somewhat
too much to expect the newspapers to do an adequate Job of
educating the public on hospital matters, as evidenced by an
experience in which the local hospitals practiced little
public relations other than relying upon the press.29 This

same attitude was expressed by another writer who reported

 

 

‘——-~‘--“ -..-...- ‘. -—

27Julian Priver, ”Twenty Ways Our Women's Auxiliary
Polishes Hospital Service,“ Hospitals. August 16, 1956, p. 128.

28Douglas Mueller,_op. 911., pp. “-5.
29Delbert L. Price and David Kinzer, _p. c t., p. 96.

16

that the types of questions asked by persons observing a

hospital exhibition at a rural county fair indicated that the

press and radio alone had not been successful in promoting

understanding of the hospital.30
This same general attitude toward public relations and

the relatively low evaluation of the effectiveness of mass

media when used alone, to the exclusion of internal public

relations, was revealed through interviews with seven hospi—

tal administrators representing all of the hospitals in

Jackson County, Michigan.31 Each of the hospital administrators

was questioned relative to their hospital's public relations

program. The responses were highly similar in each case.

The general attitude was one of achieving public understanding

and good will by providing “good patient care“. The ad—

ministrators claimed that the hospital employees were the

crux of their public relations program because a hospital

which provides good patient care does not have a public re—

lations problem. The emphasis on the importance of mass

media techniques was somewhat underplayed, although all of

the hospitals in question had made use of various mass communi-

cations. One administrator made his position clear in

evaluating public relations in terms of internal hospital

practices as Opposed to mass media publicity by commenting to

the effect that, if the hospital personnel antagonized the

'patients and visitors or if they left a bad impression, then

 

“Cec— “ --W----_—-—— -‘—~. -

30Howard K. Read, “A Hospital Goes to a Fair,“ HOspitals,
May 1, 1958, p. #5.

318cc Chapter II, p. “7f.

 

MIA,

17

all of the publicity in the world favoring the hospital would
be of no value. Once, however, the patients and visitors were
favorably impressed with the services and care provided by

the hospital, then mass communications would be helpful in
promoting good will and understanding of the hospital.

In summary of the position taken by public relations
minded hospital administrators, as revealed in articles on
hospital public relations written by them{ the chief purpose
of public relations is seen to be the achieving of an under-
standing public which extends good will toward the hospital.-
:Thi§_is—axpected to be achieved first and foremost by pro-
viding services and care for the patient which are felt to
render the patient favorably inclined toward the hospital.
Mass communications are seen to be the follow-up of internal
public relations practices. That is, once it is felt that
the hospital has been successful in developing a favorable
impression on the patients, these persons will then exhibit
an understanding attitude which will permit mass communications
to be effective in promoting understanding of hospital affairs
and problemsij’fiess eemmunications used exclusively, without
internal public relations practices, are felt to be ineffective
because patients were not favorably inclined toward the
hospital; and because of this they rejected the publicity
favoring the hospital as being unworthy of serious consider-

ation.

I --‘

18

Impligit Assumptions lg the Hospitgl Administratorig View

Publig'Relationg Indicating Agreement with 3113 Concept 9;

Achieving Consensus yithin the Mass Sggiety Through Apply;
gggss Communications

 

 

 

 

B39.

 

There are a nuMber of tacit assumptions made by the
public relations minded hospital administrator, regarding the
ability of public relations practices and mass communications
to bring about consensus and cohesion among members of
society. These assumptions are highly suggestive of the con-
cept held by some sociologists and widely held by public re-
lations men in general, that mass communications provide a
means of developing and maintaining cohesion and consensus
within a disorganized group. This concept is found to be in
association with the theory of Mass Society as advanced by
Louis Wirth and others. A brief discussion of the theory of
Mass Society and the concept of cohesion by mass communi-
cations, will cl-rify the relationship between this concept
and the position of the public relations minded hospital

administrator.

Mass Sgciety / /
V/
Probably the most articulate statement of the Mass

Society has been made by Louis Wirth. According to Uirth,

the mess society, first,

...involves great numbers. Second ... almost by
definition, it consists of aggregates of men widely
dispersed over the face of the earth, as distin-
guished from the compact local groups of former
periods. Third, the mass is composed of heterogeneous
members in that it includes people living under widely
different conditions, under widely varying cultures,
coming from diverse strata of society, occupying
different positions, engaging in different occupations,
and hence, having different interests, standards of

19

life and degrees of prestige, power and influence.
Fourth, the mass is an aggregate of anonymous
individuals ... Fifth, the mass does not constitute
an organized group. It is without recognized leader-
ship and a well-defined program of action. Sixth,
the mass has no common customs of traditions, no
institutions and no rules of governing the actions
of the individuals. And finally, the mass consists
of unattached individuals, or, at least, individuals
who, for the time being, behave not as members of a
group, playing specific roles representative of
their position in that group, but rather as discrete
entities. In modern urban industrial society, our
membership in each of the multiple organizations to
which we belong represents our interests only in,
some limited aspect of our total personal life,3£

‘i Wirth's main emphasis is, then, on the heterogeniety of
_Eogigty and the implication that there is no common basis

for behavior. ‘Herbert Blumer, another supporter of the

M...—

msss society, has described it in terms of disorganization
or lack of direction in behaviorg:]

...the mass can be viewed as constituted by de-
tached and alienated individuals who face objects

or areas of life which are interesting, but which
are also puzzling and not easy to understand and
order. Consequently, before such obJects, the
members of the mass are likely to be confused and
uncertain in their actions. Further, in not being
able to communicate with each other, except in
limited and imperfect ways, the members of the

mass are forced to act separately, as individuals.33

lg.“
‘
u

L,§11°t Freidson has described the behavior of the mass as
representing essentially individual behavior which has no
direction in terms of being influenced by others. jThis would

____.a-4

be the case as according to the other descriptions of mass

 

32Louis Wirth, "Consensus and Mass Communication,"
American Sociological Review 13: l9h8, pp. 2-3.

33Herbert Blumer, “The Mass, The Public, and Public
Opinion“, figgggg $3 Public Qpinion 93g ngmunicgtgon, Ed.
Bernard Berelson and Morris Janowitz, (Glencoe: The Free
Press, 1950), p.4h.

 

20

society, there is really no societal character to it at all.
Within the non-societal mass, behavior is determined only by
each individual attempting to gratify his own needs.3h

Unificaticn_g£_thg Mass Societygy,ygg§_gggmunicatiggg
Running simultaneously with the discussions on mass
society is the further position that it is possible to unify,
integrate, or establish consensus within the mass through
the use of the various mass media. Lazarsfeld reported that
when mass media first began to stir the imaginations of people,
many were of the opinion that mass media would reconstruct
the atmosphere of the village within the large metropolitan
centers. It was felt by many people that the spirit of the
town meeting could be produced by exposing all members of the
community to informative materials.35 The image of all
society and mass communications held by these people, accord-

ing to Lazarsfeld, was of,

An atomistic mass of millions of readers, listeners
and movie-goers prepared to receive the Message; and
secondly, they pictured every Message as a direct
and powerful stimulus to action which would elicit
immediate response. In short, the media of communi—
cation were looked upon as a new kind of unifying
force —- a simple kind of nervous system -- reaching
out to every eye and ear, in a society characterized
by an amorphous social orgagézation and a paucity

of interpersonal relations.

 

3“Eliot Freidson, “Communications Research and the Con-

cepg 3f the Mass,“ American Sociological Review 18: 1953,
p. 1 .

35Elihu Katz and Paul F. Lazarsfeld, Personal Influence,
(Glencoe: The Free Press, 1955). D. 15.

36Ibid., p. 16.

 

 

 

organ
out i

COUEU

COTS‘

21

The position that mass media serve to integrate a dis-

organized mass and bring about consensus is not entirely with-

out its backers today. Wirth would have us believe that mass

communications are capable of providing either unity or

further disorganization, depending on the motives of the

communicator.

The instrumentalities of mass communication lend
themselves particularly well to the dissemination
of (integrative symbols) on a scale hitherto
thought impossible. we happen to live in a world
in which despite barriers of technology and of
politics, the whole human race becomes potentially
exposed to the same symbols. They are weapons of
offense or defense, and they are bonds of union or
discord, depending up037the purpose which those who
use them have in mind.

Wirth feels
integration
appreciated
municstions

or prove to

that the power of the mass media as a force of
and building consensus has not yet been fully

or determined. He further feels that mass com-
as distributed by the various media may be basic,

be basic, to all other forms of power because of

the potential for deve10ping consensus.

In mass communications we have unlocked a new social
force of as yet incalculable magnitude. In compari—
son with all previous social means for building or
destroying the world this new force looms as a
gigantic instrument of infinite possibilities for
good or evil. It has the power to build loyalties

and to

hinder

power.

undermine them, and thus by furthering or

ggg consensus to affect all other sources of

Blumer imputes cause of both disorganization and inte-

gration to the power of the mass media.

-—- ’W-C.--‘-. ~~ -- -m»- '9‘-..-

 

“i... ..

 

37Louis w1rth,_op. 941., p. 6.
38.1219... p. 12.

22

Under conditions of modern urban and industrial

life, mass behavior has emerged in increasing

magnitude and importance. This is due primarily

to the Operation of factors which have detached

people from their local cultures and local group

settings. Migration, changes of residence, news—

papers, motion pictures, the radio, education —-

all have operated to detach individuals from

customary moorings and thrust them into a new and

wider world. ...At such times (the mass) is

likely to be influenced by excited appeals as

these appear in the press or over the radio...39

Blumer is somewhat more conservative in his claims for
the power of mass media than is Wirth. However, the impli-
cation for the consensus developing potential for mass media
remains very much a part of Blumer's thesis. He goes on to
explain that the disorganized mass, when reacting to the
press or radio, expresses a difference of Opinion at first.
Such differences of opinion are sired through the mass media,
producing discussion through which public Opinion. eventually

no

becomes unified. The mass media are seen as playing the
most crucial role in the development of consensus or unified
public Opinion in that the degree to which public discussion
is effective is directly dependant on the availability and
flexibility of the agencies of public communication, such as
the press, the radio, and public meetings.41

Evidence of this position on mass communications and its
ability to bring about unification of a detached or dis-
organized society is frequently found in both public relations

as well as mass media literature. While often this position

 

 

.— “ ...—u.» ~4.-—- e --m ~~o maq-—‘ — ~— 0 C- "‘ C ‘

39Herbert Blumer, 92, 9;£,. p. #5.
“01bid.. p. 47.
“11112.. p. 1+9.

23

is the unverbalized assumption upon which comments are made,
many actual written assertions of the integrative nature of
mass media may be found.

A book which was written to promote the use of radio
contained the following comment on the potential influence
of local radio stations, which provides a clear example of
the concept of the integrative power of mass media:

The opportunity is two fold -- to increase social
solidarity within communities by bringing tension
and difference out into the Open, and to relate
national and global issues, in relevant terms, to
the immediate interests and environment of the

local listener. Over the local stations the chances
are far greater Of achieving a modern counterpart

of the old town meetings. A fuller sense of
participation (because of greater knowledge and a
more immediate sense of the relevance of local
issues raised) can be achieved. At the local level
too, radio discussion has a far better chance of
resulting in actual decisions. Local radio stations
might easily become the most vital influence fin a
community for harmony and OOOperative action. 2

In another source on radio, a comment is made that would
imply integrative powers to the radio, by virtue of the
tremendous effectiveness of radio as a means of communication
attributed to it by the author. The writer's position was
made clear in a short discussion of the potential consequences
Of applying radio for the purpose of general education. The
writer maintained that such action would result in the imme-
diate loss of Jobs for an “immense army of teachers and
others employed in the maintenance Of our school systems",

and that all related occupations such as book publishers

”ZCharles S. Siepmann, Radio's Second ghance. (Boston:
Little, Brown and Company, 19555 p. 127.

 

24

and public transportation employees would suffer immediate
unemployment.“3 That radio is capable of producing this type
of result is a point seriously in doubt.

Morris Janowitz has attempted to develop a case for the
capacity of the community newspaper to develop and maintain
some degree of social solidarity and community ooncengug,
Janowitz felt that the local, community newspaper, by writing
about local peOple and events provided a reinforcement of com-
munity cohesion and integration. The following statement is
felt to be representative of the position advanced in
Janowitz's study.

If the individual has any personal knowledge of these

persons and institutions (which have been discussed

in the local newspaper) close at hand or any sense of

identification with them, he in turn feels a sense of

iglggggétzuand cohesion well beyond merely being
This point cannot be disputed)but the representativeness of
the total pOpulation of newspaper readers who would be in a
position to have "personal knowledge of” or feel “close at
hand“ with those persons and events which are likely to be
discussed in the community newspaper may be seriously
questioned. The segment of the population which would feel
any enhancement of cohesion with the community would more than

likely be a relatively small, select group to begin with.

Persons and events with which the bulk of the community's

 

--- VhA

”3Anthony B. Meany, Radio-21: Perils to Prosperity
(New York: Pageant Press, Inc., 19555, p. 957

“unorris Janowitz, The Community Press in an Urban
Setting (Glencoe: The Free Press, I9527, p.-l577

25

population might be familiar are not generally those persons
and events which are discussed in the newspaper,

Bernard Rerelson is willing to attach some small amount
of consensus producing ability to the press, but not without
strong reservations. He would maintain that the appearance
of an issue in the press over a prolonged period of time may,
in some way, give the impression of having produced consensus;
but he feels that the more basic effect is one of forcing
#5

people to make up their minds on the issue. He would con-
tend that the person's personal predisposition on the issue
would determine the nature of his decision. Those persons
who did not previously have a well developed predisposition
on the issue might be induced to take the position being ad—
vanced in the press or other medium of communication, and
given that the existing predispositions on the issue were
evenly divided, then the final outcome of decisions would
place the position of the press in the majority.

Content emphasis increases agreement, but it is not

so strong determinant of agreement as predis—

position.’+5

The following classic proposition of Berelson's would
further discourage counting him among the followers of the

belief that mass media are capable of unifying a mass society:

Some kinds of communications on some kinds of issues,
brought to the attention of some kinds of people

-“-—.--.-O‘-.—.~ ..- o - A ‘...“

 

““‘fl --‘-----~-

“SBernard Berelson, ”The Effect of Print Upon Public
Opinion", Print, Radio and Eilg in g Demograc , Douglas
Naples (Chicago‘ The University of Chicago ress, 19b2),
P. 3.

”61bid., p. 5h.

 

 

 

g.
26

under some kinds of conditions, have some kinds

of effects.

Public relations literature has also contributed to the
support of the consensus producing ability of mass media and
is, in fact, to some extent, basically premised on this notion.

Kl

[\One writer on the subject of public relations contends that
the optimum task of public relations is the development of
“rapport“ (which might be construed to be some form of con-
sensus) between the various diverse groups that comprise a
public.#§:]

Another example is found in the accounts they give for
why public relations (as relying almost exclusively on the
use of mass media) exists. One writer has stated the fellows
ing conception of the origin of public relations:

Public relations is a phenomenon and a necessity

of our times. It has been created by the forces

that increased the tempo of the world, cast people

into many diversified groups, all seeking different

objectives yet all having to wogg together toward

common advantages and progress.

Here, the inference is that public relations will serve
to reconstruct that set of cooperative relationships that
existed previous to the events which “cast people into many
diversified groups.“ As the public relations man has already

been seen to rely for the most part on the use of mass media,

then it would follow that he intends to reconstruct cooperative

u7Bernard Berelson, “Communication and Public Opinion,“
Bernard Berelson and Merrie Janowitz ed. Reader ig_Pub;ic

Opinion and Communicatiog (Glencoe: The Free Press, 1950),
P. 51.

“Bahamas 9. Steinberg, Qp. cit., p. 31.
”Philip Lesly, 92. cit., p. u.

27

relationships through the application or mass communications.

Another public relations writer develops the same position
but goes on to maintain that it was the industrial revolution
which caused the original disorganization. The writer, rather
dramatically, contends that,

...individuals and institutions of all kinds were

broken loose from their moorings and cast adrift

upon a tide of uncertainty and uneasiness. Added

to the existing tendencies breeding social tensions

and disrupting smooth relations among people and

institutions, the elements of fear and uncertainty

made demands that brought public relagions to the

fore. It quickly became a necessity. 0
While, again, the author does not actually say that public
relations,through the application of mass communications, is
going to remedy the situation of social disorganization that
is felt to exist, the inference is that public relations and
mass communications will achieve Just that.

A final example of the consensus and cohesion theme
which runs through a great deal of the public relations
literature is taken from a proposal written for a publicity
campaign designed to promote favorable attitudes toward a
bond issue for the construction of a new wing of a community
hospital. The proposal was written by a professional public
relations man who had this to say about the goals of the
publicity campaign:

Another goal is the utilization of this campaign as

a unifying factor in the community relations at

large. between tightly-organized labor groups who

normally do not cooperate with other elements of

the community, management groups who have the same
introspective viewpoint, local neighborhood clans,

‘.—~~--~m--“‘----“.—H “...-“ou- 4— —-0 - com- -m-m‘ l A‘-

50Rex F. Harlow and Marvin M. Black, Eggqfiqul Publiq
figlgtiggg (New York: Harper and Brothers, 1952), p. 5.

 

 

N
(1),.

PTA‘s, clubs, everybody. If they can get to—

gether even in such an obvious effort as this,

they might stay together for awhile a d permit

other community needs to be surveyed.
The unification, cohesion theme of this statement is self-
evident. Emphasis on the consensus producing ability of mass
media was likewise specifically advanced in the publicity
campaign proposal.- The writer of the proposal claimed that
“unanimous agreement“, which would be another term for con-
sensus, was going to be achieved by making use of “every form
of public address -— newspaper, radio, direct mail and

meetings...“52

§E~ujaa:fi:ip~s$n£a‘uact°-fi

(:Btated very simply, the concept of the unification of
the mass society through the application of mass communi-
cations involves the conception of society as being composed
of numerous peOple representing heterogeneity and diverseness
to the extent that there exists no common basis of behavior
icy the members of the society. Mass communications are seen
to provide the only common experience upon which directed and
organized behavior could resultJZCThe assumption which the
public relations minded hospital administrator makes in his
public relations scheme is that the experiences received
through hospital "public relation practices“ by those persons
who are hospital patients, provides a common basis of ex-

perience on which a unified Opinion of hospitals is expected

51Kent Sagendorph, “Help Your Hbspital Campaign", Un—
published paper, Jackson, Michigan, 1957, p. 2.

522mg” 1:. 6.

29

to emerge§JEThat is to say, it i§_assumed that all patients
will receive experiences while in the hospital, which are in
fact the same experiences for all patients, and that further,
(:the interpretations patients make of these experiences will
result in unanimous consensus, in that all patients will
henceforth be favorably inclined toward the hospital; In the
case of the position of those who adhere to the concept of
unification of mass society by mass media, the basis of common
experience is the reception of mass communications; whereas
in the case of the hospital administrator's position, the
common basis of experience is viewed as the reception of
public relations practices in the hospital.<Lihe hospital
administrator would then contend that the application of mass
communications favoring the hospital would act as reinforce—
ment of the consensus of Opinion regarding the hospital
among former hospital patients.;!

Both the concept of the unification of mass society by
mass communications, as promoted by Wirth and Blumer, and the
hospital administrator's view of providing consensus among
hospital patients by applying “public relations practices“,
are based on the same assumption involving common experience.

The public relations minded hospital administrator is
willing to attribute consensus making powers to mass communi-
cations but in a somewhat more restricted capacity than those
who follow Wirth and Blumer. The difference results from the
different conceptions of how the common basis of experience

is achieved and in the interpretations of the composition of

society. Those who follow Wirth and Blumer conceive of mass
communications as providing a common basis of experience for

a highly segmented and heterogeneous society; whereas, the
hospital administrator, insofar as the mass communication in
question is hospital publicity, and in maintaining that hospi--
tal experiences provide the common basis of experience, would
conceive of society as being composed of only two general
classes of people. That isyithe hospital administrator
recognizes the hospital publicity receiving public as being
composed of ”former hospital patients" and "non-former
hospital patients”. Thus, the hospital administrator would

be willing to attribute consensus making powers to hospital
publicity in that those who are former hospital patients

will, in receiving the publicity, tend to reinforce or solidify
their already favorable impression of the hospital::

The hospital administrator would arrive at the two-class
conception of community composition in respect to the reception
of hospital publicity because of his belief that mass communi-
cations used alone, to the exclusion of internal hospital
public relations practices, will be ineffective. He has
maintained that once public relations practices have been
established within the hospital, then mass communications
which promote the needs of the hospital will be given serious
consideration by those who have been hospital patients4::ln
other words, former hospital patients, because of their shared
experiences of having been exposed to ”public relations

practices“ within the hospital, will give serious consideration

31

to hospital publicity; whereas those who have not received
”public relations practices" in the hospital will not
seriously consider hospital publicity:7 Thus. by implication,
the hospital administrator recognizes only the two classes
of people in respect to the reception of hospital publicity;
namely, ”former hospital patients“ and “non-former hospital
patients”.

Because the hospital administrator's frame of reference
in viewing mass communications is limited to the specific
context of hospital publicity and the consequent recognition
of only two classes of people, “former“ and “non-former”
hospital patients, he has broken with the more generalized
conception of mass communications as advanced by Wirth and
Blumer. Hewever, in doing so, the public relations minded
hospital administrator is forced into making further related
assumptions regarding mass communications, which merit special
consideration.

It has been established that the public relations minded
hospital administrator has maintained that of the hospital
publicity receiving public, those who are former hospital
patients will give more seridus consideration to hospital
publicity, due to their exposure to hospital ”public relations
practices”, than those who are not former hospital patients.
Therefore, it would have to be assumed that in order for one
to give more serious consideration to hospital publicity, one
would have to give more attention to it than those who do not
give serious consideration to it, and consequently, the extent

or degree of reception of hospital publicity would have to

32

be greater. Thus, the hospital administrator would have to
maintain that the extent of reception of hospital publicity
would be greater among former hospital patients than among
non-former hospital patients.

In doing so,Z@he hospital administrator has maintained
that the extent of reception of hospital publicity is dependent
upon exposure to hospital experience;]Zlf this is so, it would
likewise be plausable to assume that those former hospital
patients having greater exposure to the hospital would ex-
hibit greater reception of hospital publicity than those a.
former hospital patients having less exposure to the hospital.

This being the case, the hospital administrator would
then have to maintain that former hospital patients would
exhibit no intra-class characteristics which might account
for the reception of hospital publicity. This would preclude
the possibility of such factors as differential age, sex,
occupation, education, etc. as having any effect on the
extent of reception of hospital publicity.

The position taken by both those who adhere to the unif
fication powers of mass communications as advanced by Wirth
and Elumer, and by the public relations minded hospital -
director, does not hold up well in the face of mass communi-
cations research findings. There is an abundance of literature
in the field of mass communications which would cast serious
doubt on these assumptions, found implicitly imbedded in
Wirth's and Blumer's position on mass communications and in

the position taken on mass communications by the hospital

33

administrator. That these assumptions are untenable will be
demonstrated in the following survey of research findings from

the field of mass communications.

Mass Communications fiesearch Findings

 

One of the most outstanding studies done, which would
tend tofgiscourage placing a great deal of faith on the ef-

fectiveness of mass media in general; was done innpincinnati

.4

in an attempt to promote understanding and interest in the

United Nations;7 A previous survey had revealed that/a certain

\—5#

segment of the Cincinnati population was both uninterested and

uninformed about the United Nations. Anmass media campaign

PM“.
—.
—-—._. ._______

was designed to reach these peOple and every available means
of communication was employed: newspapers, radio spots, signs
and posters, street car cards, direct mail, meetings, leaflet
and pamphlet distribution were used in order to promote

interest and information. After six months of intensive

H.___-___'_- -....— fl-—

campaigning a second survey was taken. Theééesults showed
that those persons who had originally been informed and“
interestedflhad received the publicity whereas those persons
whofihadbeen identified as the uninterested and uninformed,
and towards whom the campaign was directed, had failed to

assimilate the publicity and remained uninterested and un-

\_____..

informed. The writer of the report concluded that,
.the surveys indicate that peOple who have pre-
existing favorable attitudes are the ones who will
pay attention to publicity. That is, that people
seek information which is congenial to their- attitudes.3

“-v‘~q-fl-_-‘ ----.mm“-c-«o a*“--‘

53Shirley Star and Helen M. Hughes, “neport on an
‘Educational Campaign: Cincinnati Plan for the United.5btions",
American Journal o__f_'_ ggciologz 55: 1950, p. 398.

 

. -.il.ili. ma... ...IU.

34

Further data were provided by this study, however, which
serves to substantiate a position taken by many writers in
the field of mass communications, namely, thatithe reception
of serious or educational publicity tends to be positively
correlated with socio-ennnomic status as measured by a
variety of indices. film this case, the level of education
provided further weight to this proposition. The author of
the report claimed that 68% of the college educated informants
received information through three or more media, while only
43% of the high school educated informants made the same
claim, and 17% of the grammer school educated informants
claimed to have received information through three or more
different media.5h

Léther research has likewise indicated that serious or
educational publicity,_as apposed to publicity of a purely
amusement type, is more readily received by persons of
relatively higher socio-economic status.; A study which in-
volved ”leadership" done by Katz and Lazarsfeld concluded
that both the amount of knowledge and interest in public af-
fairs increases with socio-economic status.55 As a part of
their study, Katz and Lazarsfeld asked informants to identify
persons whom they felt to be influential and expert in public
affairs. They found that,

Each of the three major criteria of social and

economic status that are available indicates that
the persons designated as generally influential

 

sumo, p0 397.
552nm Katz and Paul F. Lazarsfeld, 212. c_1_i., p. 27h.

35

are higher up on the status ladder than the people

who named them, and that each successive group of

experts stands higher than its predecessor; this

is true of income, of the intuitive rating of socio-

economic staggs employed by our interviewers, and of

occupations.
This, coupled with the further observation that those persons
designated as influential and eXpert in public affairs, as
well as other areas of interest, were relatively more ernosed
to all major forms of mass communications57 would add further
impetus to the preposition that reception of serious or edu-
cational publicity tends to be positively correlated with
socio-economic status.

Wilber Schramm and David White have also provided re—
search findings which would tend to confirm this prOposition.
A study of newspaper reading, in terms of social characteristic
factors, showed that in general there was a close positive
correlation between the reading of serious or educational
news and a number of indices of socio-economic status.58
They claim, on the basis of their research findings, that,

...it appears that readers on the lower end of the

educational curve tend to use the newspaper for

entertainment, sensational news, and pictorial

material. Those at the top of the educational

curve tend to use it less for entegtainment, more
for information on public affairs. 9

56ihia.. p. 283.

57Ipia.. pp. 310-311.

58Wilber Schramm and David M, White, ”Age, Education,
Economic Status: Factors in Newspaper Reading", gournalisg
Quarterly. June, l9h9, p. 150.

59lhid.. p. 15a.

36

In a later report, Schramm offers the suggestion_that news
associated with such topics as crime, corruption, accidents,
disasters, sports, society and human interest provide the
reader with an immediate reward. News associated with such
topics as public affairs, economic matters, social problems,
science and education provide the reader with more of a de—
layed reward. He contends that reading for delayed rewards
is a more sophisticated form of learning behavior which is
closely associated with higher education and "similar
experience”.60

The same general findings have resulted from studies
of radio listening. H. M. Beville reported finding that
radio programs having an educational or seriOus appeal were
followed most frequently by persons of relatively higher in-
come groups.61 “This heavy skewing toward the upper (income)
groups is characteristic of educational programs of serious
content.”62

Lazarsfeld sights the optimistic attitude of some edu-
cators that radio would bring education and serious content
to persons of low educational background and low income.
He devised a "cultural level” index in which informants were

classed on the basis of occupation, education, telephone

ownership, and reading habits. A study of actual radio

6OWilber Schramm, "The Nature of News“, igurnalism
Quarterly, September, l9h9, pp. 259—269.

61H. M. Beville, Jr., "The ABCDs of Radio Audiences”,
Public 22inion Quarterly, June, l9h0, p. 202.

62irig.. p. 203.

37

listening habits showed that people actually do less serious

listening as the “cultural level” descends.63 In a more
recent book,-Lszarsfeld reports the following:

Programs of serious music and discussion of public
issues are selected as favorites twice as frequently
in the college group as in the grade school group.
In other words, the program types which reveal most
marked differences in tastes are those which have
come to symbolize radio's cultural or educational
mission. They are favorites of the highly educated
listeners, but they hold relativelg little appeal
for listeners on the lower strata.

Lazarsfeld claims that his research findings of radio
listening revealed that 63% of the college educated people
interviewed selected “public affairs“ as a favorite type of
radio program; £35 of the high school educated informants
selected "public affairs”;wheress only 35% of the informants
who had received less than high school educations selected

"public affairs“ as a favorite type of radio program.65
F“

[Alt is clear that educational or serious type of radio

programs and newspaper articles are not received by the less

H

educated and lower paid segments of our population._ The
American policy on broadcasting and newspaper writing is to

”give the audience what it wants".66 The audience, in this

63Paul F. Lazarsfeld, Radio and the Printed Page. (New
York: Duell, Sloan and Pearce, 19QO), p. 21.

6“Paul F. Lazarsfeld and Patricia L. Kendall, Radio
Listening in America (\bw York: Prentice-Hall, Inc. , 1948),
p. 25—

65Paul F. Lazarsfeld, ”Audience Research", Reader in
Public inion and Communication, Bernard Berelson and Morris

----“

ianowitz Glencoe: ‘The Free Press, 1950), n. 339.

66Judith C. Waller, Radio — The Fifth Estate (Boston:
Houghton Mifflin Company, 1936), p. “8“

38

case, is made up chiefly by people who are "less educated"
and “lower paid". Gordon Allport has claimed that one of
the reasons for this apparent rejection of programs and news
articles of a serious nature, such as discussions of public
affairs, is that consideration of such matters is an anxiety
producing situation. "...the average man (desires) to be
freed as quickly as possible from the tension or worry and
annoyance in matters of public policy".67 This being the
case, it is increasingly difficult to believe that any great
number of people are going to voluntarily place themselves
in a position of being confronted with weighty problems of
public affairs.

It has been the conclusion of many researchers in the
iicld of mass media that the actual effect of mass media in
contributing to decisions on public affairs matters is
practically nil. If the communication contributes anything
at all, it serves to force a decision.68 This does not imply
that the position being advanced in the communication will be
advocated by the recipient. Rather, as Berelson has stated
it:

...the whole complex of social characteristics -

income, occupation, education, age, sex, religion,

group membership and group loyalties, and so forth

...inclines peOple confronted with public issges
to respond in certain ways and not in others. 9

 

67Gordon W. Allport and Janet M. Feden, "The Psychology
of Newspapers: Five Tentative Laws", gublig Qpinion Quarterly,
December, l9u0, p. 702.

 

68Bernard Berelson, 1952, p. 53,.
69Ibid., p. #9.

39

Berelson is not alone in this view. Lazarsfeld has also
arrived at this conclusion, based on many years of research
in mass communications. He has claimed that an individual‘s
decisions on matters of public affairs and issues are deter-
mined primarily by e few of his social characteristics -
religious affiliation, amount of schooling and economic level.7o

Public fielatiogg and ggcial Science

 

It would be misleading not to account for a small minority
of public relations writers who recognize that the findings
of mass communications research place serious limitations on
the effectiveness of mass media. Charles S. Steinberg, in a
recently published book on public relations, has included some
research findings which indicate that a media receiving public
may be stratified by social class, and may be, in fact, many
different publics, all of whom receive the communication
differently.71 Likewise, Rex F. Harlow has recently published
a book which is an attempt to bring public relations practices
into closer harmony with the finding of social science. 72
These two sources are not, however, representative of the
general field of public relations literature. The majority
of sources would remain in agreement with Wirth's belief that

the only thing holding what is felt to be our disorganized

 

70 Paul F.1azarsfe1d."The Effects of Radio on Public
Opinion", Print, Radio and Film in a Democracy, Douglas
Naples (Chicago The Uni varsity Of" Chicago Press, l9h2),

P 72.
71Charles S. Steinberg,_22. 2;}.

72Rex F harlow. Social science in Pub blig _§;§§199§
(New York. Harper and Brothers, 19377.

4 \.
liivfis..i—

“a

J Coll. .
I .

#0

and highly segmented society together, is mass media.73

Fallacy g: the Position that Mass Media ޤye_Unification
aware. and of the Position of Public Relations Minded

~~M~

Hospiigl édministigfprg fiegarding Mssg Communicatiogg

 

 

 

 

The above review of mass communications research findings
would tend to indicate that the position held by the followers
of Wirth and Blumer, and the position held by public relations
minded hospital administrators, that mass communications pro-
vide a powerful enough stimulus to promote unified action and
consensus, is erroneous. Star, in reporting the failure of
the Cincinnati publicity campaign for the dissemination of
information on the United Nations, concluded that:

If pamphlets are not read, if radio announcements

are not heeded, or if meetings are unattended, then
success in providing information stops right there.

7h
Replication of this conclusion is a familiar finding in a re-
view of mass media research literature.

Of particular interest is the:research finding which would
indicate that the reception of public affairs publicity is
closely associated with social characteristic factors, such
as age, sex, occupation, education, income, etc. In this
respect the research also pointed out that the extent of
reception of public affairs publicity tends to increase in
the direction of increasing social status; élt will be recalled
that one of the implicit assumptions made by the hospital

administrator, in his public relations scheme, was that the

reception of hospital publicity (of which a great deal is

 

73Louis Wirth, Qp. cit., p. 10.

7”Shirley A. Star and Helen M. Hughes, 22. Q1£., pp.

it'll-133.3: .mrll. . . ....

#1

public affairs) is associated only with the exposure to
hospitals. He has further contended that the extent of re-
ception of hospital publicity would increase with greater
exposure to hospitals.j)

It is these last two assumptions of the public relations
minded hospital administrator which provide the central
focus of this study. Research findings have been produced
which would contest these assumptions. Hewever. in order
to empirically test either the accuracy of the hospital ad-
ministrator's assumption or the accuracy of the research
findings, certain conditions must be present.

anditions Necessapy for the Study 2: Reception 25 Eggpitgl
Publicity
In order to put to the empirical test any proposition

 

concerning the reception of hospital publicity, it would
first be necessary to locate a community in which the local
hospital or hospitals, had become highly prominent in public
affairs. This would be necessary due to the over-all slight
number of communications which ordinarily pass through to the
community about hospitals, under normal conditions, when the
hospital is not involved in public affairs. Further, the
over-all quantity of news tapics dealing with public affairs
in general is slight. Swanson, in a study of newspaper content
discovered a general lack of news t0pics dealing with public
affairs and specifically with local government. In a general
category of "news-editorial—feature“ types of newspaper

content, "local government” as a single class received only

> in.“ agindhfl w . .11?“ ”a 4mg”. . to

#2

1.5% coverage in comparison with all other classes of news.75

In order to obtain any evidence of reception of local
hospital publicity, a situation in which the local hospital
or hospitals had become a source of major concern in public
affairs would have to be located. Preferably, a situation
in which the local hospital or hospitals had become the
center of controversy over an issue which would produce
partisan followers. Thus, in order to promote a following,
those involved with the controversy would_make use of every
available means of communication. The hospital would then
receive a great deal of publicity; more_so than during times
when the hospital was not the source of any conflict.

Conditions Under Which This Study Was 90nducted

 

Jackson, Michigan, is an industrial community in the
south-central part of the state. The current population of
the city has been estimated to be about 52,550.?6 The chief
industrial activity in the community is the production of
automobile parts and tires.

There are a total of seven hospitals in the county, all
of which are either within the corporate limits of the city
of Jackson or immediately adjacent to it. Of these hospitals,
two are general service medical hospitals, one is a general
service osteOpathic hospital, one is a general service
proprietary hospital, one is a tuberculosis sanstorium

maintained by the county, and the remaining two are county

75Charles E. Swanson, "What They Read in -130 Daily
Newspapers“, Journalism Quarterly, Fall, 1955, p. #17.

76Estimate made by the Planning Commissioner of the
City of Jackson.

1+3

welfare maintained institutions. Of the two general service
medical hospitals, one is operated by the Catholic church and
the other is a,publicmtax supported hospital. It is this
latter hospital which provides the focus for this study of the
reception of hospital publicity.

In 1957. the board of directors of the tax supported
hospital, callediFoote Hospital;?determined that in order to
provide for much needed additional facilities, a new wing
would have to be constructed on the hospital. As a tax sup-
ported hospital, there was not available sufficient funds to
permit the construction of new facilities. A general
obligatory bond issue was thought by the board of directors
to be the best solution to the financial problem. The year
previously, Mercy Hespital. the Catholic hospital, had con—
ducted an extensive fund raising campaign, so that the board
of directors felt that "hospitals" were probably "on the
public mind", but that another fund raising campaign would
not be well received. The use of a bond issue was likewise
felt to present problems in that the use of public taxes to
pay off a bond issue for the hospital required a revision of
the city charter, obtainable only by a vote of approval on
the part of city voters.

As it was anticipated by the board of directors that the
voters of the community would fear an increase in taxes, a
publicity campaign was designed to gain the support of the
public through general education to the problems of the

hospital as it then stood, and through the general understanding

,DSI‘i‘P um.“ ,..0~

an

of the bond issue prOposals.

Included in the publicity campaign was a thorough use
of the community newspaper during the month and a half that
the campaign went any extensive radio discussion and spot
announcing; aggpeaker's bureau sent representatives to meet
with 72 different organizations representing service clubs,
labor locals, fraternal organizations, church and women's
clubs; folders on the bond issue containing information about
Foote Hospital were distributed to “every household in
Jackson"; lioposters were placed in store windows and on

lighthposts throughout the community; and six full sized

advertizina hill boards were used.

 

During the normal course of events in Jackson. the local
hospitals received comparatively little publicity, although
all seven hospitals made some use of mass communications.
Occasional speeches are made to local organizations, and an
occasional news item appears in the press. Two local radio
stations report hospital news only as it is received from the
press and include a listing of all births for the day. Both
the newspaper and the radio stations publicize annual hospital
events such as hospital Open-houses during National Hospital
Week, the “Pink Ball", 8 dance sponsored each year by Mercy
Hospital, and an annual fashion show sponsored by Foote
HOSpital's women‘s auxiliary. Literature about the two
general service medical hospitals is supplied patients upon
entrance to the hospital, but no attempt is made to distribute

literature to the non-patient community members.

45

While the general amount of hospital publicity in Jackson
is slight, the incident of the bond issue provided a great
amount of publicity concerning Foote Hospital. As such, a
situation was deve10ped which permitted a study of the re-

ception of hospital publicity.

Statement 2: Hypotheses

 

Given this situation in which a local hospital became
prominent in local public affairs, serious attention may be
given to the prOpositinn affirmed by public relations minded
hospital administrators, that the reception of hospital
publicity is associated only with exposure to the hospital.
Likewise, the prOposition affirmed in the mass communications
research literature may be investigated. That is, that the
reception of public affairs publicity (as was the hospital
publicity in Jackson) is associated with social characteristic
factors and with socio~economic status.

The following general hypothesis is submitted;

Among former hospital patients, the reception of

hospital publicity will be associated with

socio~economic status.
In order to provide a test of association between the re—
ception of hospital publicity and socio-economic status, the
following working hypotheses are submitted:
1. Among former hospital patients, reception of hospital

publicity77will not be associated with occupational
ratings.('

 

”-‘a—“-m--.ov-fi-“.oo--“-‘-fl-‘A—‘ *‘m-«C‘-‘—Ci--.._

77See Chapter II,poges 63—65 for’details on scoring
the reception of hospital publicity.

78See Chapter II, page 66 for a description of the
(Docupetional ratings used.

... . . .1311
1..qu . 1 _

he

2. Among former hospital patients, reception of hospital
publicity will not be associated with income ratings.79

\3
0

Among former hospital patients, reception of hospital
publicitg will not be associated with educational
ratings. 0
u. Among former hospital patients, reception of hospital
publicity will not bg associated with membership in
local organizations. 1
The following chapter will describe the general methods
employed in this study along with a description of the

indices used.

 

 

A“ u 0.6 —.“~

798ee Chapter II, page 68 for a description of the
income ratings used.

803cc Chapter II, page 68 for a description of the
educational ratings used,

818cc Chapter II, page 67 for a description of the
organization membership ratings.

CHAPTER II
METHODS

Hospital Public Relations 53; Publicity gggggy

In attempting to determine if the amount of hospital
publicity released in Jackson, Michigan during the year of
Foote Hospital's bond issue was of a sufficient amount to
warrant a study of the reception of hospital publicity, an
infonmal survey was made. This survey covered the general
topic of hospital public relations and publicity and was
concentrated on the local hospital administrators and repre-
sentatives of local hospital women's auxiliaries. As a check
on the accuracy of their comments, the managers of the two
local radio stations were asked to open their station's 'log'
for investigation regarding the use made by local hospitals
during 1957. Also, the local library clipping service
provided a check on the use of newspaper publicity.

Hospital Administrators

During the summer of 1958, each of the seven hospital
administrators in the city of Jackson was approached with a
simple set of guideline questions relative to the previous
year's hospital publicity activity.1 Information was gathered

1The questions used in this survey were designed only
to obtain general information and were not designed to obtain

47

#8

concerning the use of various modes of communication, the
cooperation of those who control the local newspaper and two
radio stations, the frequency of use of each mode of communi-
cation, and a general summary of the administrator's estimate
of the effectiveness of these media. Information was also
gathered regarding the administrators' feelings about the
intended audience of these modes of communication and the
reasons for aiming publicity at these people. Also, each
administrator was given an opportunity to express his feel-
ings regarding his hospital's general public relations pro-

gram.

Hgspital women's Auxiliary Representatives

In order to obtain a more thorough impression of the
local hospitals' claimed use of publicity methods and their
feelings regarding public relations, representatives from all
local hospital women's auxiliaries were questioned. The same
general types of questions asked of the hospital adminis-
trators were asked of the women's auxiliary representatives,
omitting questions involving direct administrative duties.
Only Foote, Mercy, and the Osteopathic hospitals had such

organizations.

Follow-g2 Procedure

In order to determine the accuracy of the estimates made

by both local administrators and representatives of local

 

specific quantitative data. As such, no exact interview
schedule was developed. The questions asked have been sum-
marized in the remainder of the paragraph.

 

III: hill. ullflidmhfllt a .5

1;?

women's auxiliaries, interviews were held with the managers
of the two local radio stations. An investigation of each
radio station's 'log' revealed the exact data on the use of
radio by the local hospitals.

The local community library maintained a clipping service
in which all newspaper articles regarding the local hospitals
were categorized by date and hospital. This provided an ex-
act impression of the use of newspaper as a means of dis-
seminating hospital information.2

A “speakers bureau" list of organisations provided a
means of determining which local organizations had received
speeches regarding the Foote Hospital bond issue. Speeches
regarding hospitals, but not specifically dealing with the
bond issue, were not recorded.

The admitting departments of three of the local general
service hospitals provided information regarding the distri-
bution of literature to incoming patients, and a campaign
proposal for the Foote Hospital bond issue disclosed the use
of literature for that purpose.

A follow-up on the use of displays in disseminating in-
formation about local hospitals was not amenable to direct
investigation. Only the claimed use of this device made by
hospital administrators and representatives of local women's

auxiliaries was obtained.

 

2The estimates made by both hospital administrators and
representatives of local hospital women's auxiliaries regarding
the use of newspaper and radio were found to be slightly low.
Investigation of radio station 'logs' and newspaper clippings
revealed a somewhat greater use of these means.

iiiih’ .- 4.51."; “Us“,muU‘.

50

On the basis of this information it was determined that
the amount of hospital publicity released during 1957 in the
community of Jackson was of sufficient quantity to warrant an
investigation of the reception of this publicity. The in-
formation obtained from hospital administrators and repre-
sentatives of local hospital women's auxiliary groups re-
garding hospital public relations was found to be in close
alignment with the position on public relations as advanced
in hospital Journals, so as to warrant the study of reception

specifically among former hospital patients.

Survey 2; Reception p; Hospital Publicity

T§g_8ample
' The selection of former hospital patients used in this
study was restricted by the following limitations:

1. Only persons having been admitted to the hospital
during the year 1957 were eligible for selection
into the sample.

This restriction does not preclude the selection of perb
sons who have been hospital patients both prior to or after
the year 1957. It refers only to the fact of admittance
during that year. This restriction was felt necessary in
order to assure a sample of former patients, all of whom had
been exposed to a hospital within a specified time span.
Further, the selection of the year 1957 was based on the fact
that the greatest amount of hospital publicity was released

during that year due to the occurrence of Poets Hospital's

bond issue.

51

2. Only persons having been hospitalized in Foote
or Mercy Hospital were eligible for selection
into the sample.

This restriction does not preclude the selection of per-
sons who have been hospitalized in hospitals other than Foote
or Mercy. It refers only to the fact of admittance to either
Foote or Mercy during the year 1957. These two hospitals
were selected in lieu of the others because they received the
greatest amount of publicity, Foote because the bond issue
and Mercy because of the construction of a new wing. The
Osteopathic Hospital did not receive much publicity due to a
policy of the state organization of osteopathy which dis-
courages the use of publicity. The proprietary hospital was
rejected because of having received little publicity and its
servicing of relatively few patients. Further, it is located
outside the city limits of Jackson. The remaining hospitals
were rejected because of the fact that they serve mainly
chronically ill and old-age patients, consequently, returning
few to the community.'

3. Only persons whose residence is within the city
limits of the city of Jackson were eligible for
selection into the sample.

This restriction was felt necessary in order to limit
the geographical distribution of patients to a specific
locality.

a. Only persons between the ages of 18 and 65 at

the time of admittance in 1957 were eligible
for selection into the sample.

This restriction was felt necessary in order to obtain

intelligible interviews.

52

Therefore, the sample of former hospital patients used
in this study may be said to be composed of persons between
the ages of 18 and 65, who live within the city limits of
Jackson, who were hospitalized in either Foote or Mercy

Hospital during 1957.

Selection 9; Egg Sample

In order to select former hospital patients who conformed
to the above limitations, the 1957 admittance records of Facts
and Mercy Hospitals were used. These records provided a guide
for the above limitation excepting the age restriction in the
case of Facts. The records for this hospital did not include
the age of the patient.

[:It was determined that a total sample of 100 cases would
be sufficient for a test of association between the reception
of hospital publicity and socio-economic status. Fifty were
to be selected from Foote Hospital and fifty from Mercy. How—
eygr, in order to account for a high possible number of re-
lggtions, due to leaving the city of Jackson since release
from the hospital, moving within Jackson but without leaving
a change of address, death, refusals, etc., it was determined
that at least twice the number of informants required for the
study should be selected.‘ Therefore, a total of 100 former
patients were selected from the admittance records of each

hospital.

 

An unbiased sample of 100 patients from each hospital
was obtained by drawing every'n'th' patient number from the

admittance records. “N“, in the case of Foote Hospital, was

every ninety-third patient number as the total number of ad—
mittances at Foote Hospital for the year 1957 was 9.296.3

At Mercy Hospital, the total number of admittances in 1957 was
17,6h3, so that every 176th patient number was drawn.4

In the event that the patient number drawn was attached
to an individual whose residence was listed outside of the
city of Jackson, the next closest patient number conforming to
the residence restriction was selected. In the event that
there were two such individuals residing within the city of
Jackson whose patient numbers were equidistant frmm the
original number selected, the final selection was alternated
between highest and lowest patient number. The same procedure
was used for the selection of patients conforming to the age
restriction in the case of Mercy, where age is recorded. In
the case of Foote Hospital, where age is not recorded in the
admittance records, a number of individuals were drawn into
the sample who did not conform to the age restriction. These
were rejected in the process of interviewing the sample.

The final procedure in drawing the sample was the:dividing
of the 100 patients from each hospital into a “master“ sample
list and an "alternate'| sample list;: This was done by select—
ing every other patient number for placement on the master

sample list.

 

3statistical Report for the Fiscal years 12h8-h2 thro h
1252—55 (Jackson: W. A. Foote Memorial Hospital, 1958 .

“Mercy's total annual admittance was recorded as a part
of the admittance record.

5h
During the interviewing phase of this study, when an
individual on the master sample list could not be obtained for

interviewing due to any reason, the respective individual on

a;
the alternate sample list was interviewed.“

.Qpestionna;pp,pgp;gp

A questionnaire was designed for the purpose of obtaining
a measurement of an informant's claimed reception of hospital
publicity.6 Each of the means of communication was isolated
and the informant asked if he or she had ever seen or heard
any hospital publicity from these sources. This was done with
the newspaper, radio, literature, displays and speeches.
when the informants claimed that they had received hospital
publicity through any of these sources, information was gathered
about which hospitals were involved and what the publicity
was specifically about. After each mode of communication was
reviewed, questions were asked regarding the most highly
publicized events which had occurred in 1957. This included
hospital open-houses, women's auxiliary events, and Foote
Hospital's bond issue.

Questions were also designed to provide a measurement of

each informant's “potential exposure"? to the known means of

 

58cc Table l for a comparison between “rejected” and
“replaced“ informants by age, sex, and residence.

63cc Appendix A for a copy of the questionnaire used.

7Potential exposure is defined as the fact of being con-
fronted with any means of communication containing hospital
publicity. This is distinct from actual exposure which would
be the fact of recognition and the paying of attention to the
communication.

ill-5.... _, ... . find-U»... ...r. 4 .. I..LH..\

rr
)2

communication. That is, questions were included to determine
whether or not the informant subscribed to the local news-
paper, regularly listened to local radio stations, and to
determine the extent of participation with local organi-
zations. It was felt that questions relative to the exposure
to hospital literature and displays were unnecessary due to

the known equal distribution of literature, and in the case

of displays, the widespread nature of their distribution
during the bond issue. In both cases, 'potential exposure”

was judged equal. The questionnaire was also designed to
obtain information regarding the informant's hospital ex-
periences. Questions were also asked regarding the number of
times the informant had ever been a hospital patient, total
number of times in the past two years, total number of family
admittances in the past two years, general purpose of all of
the informant's admittances in the past two years, and the

use of hospitalization insurance. Questions were also designed
to obtain the informant's evaluation of his hospital experiences
in terms of "satisfactory or unsatisfactory“ services and
accommodations.

Finally, the questionnaire was designed to obtain in-
formation regarding each informant's relative socio-economic
status. Questions regarding the occupation of both the in-
formant and the provider of the household's chief means of
support were included. The same was included regarding formal
education. Questions were included to provide an index of

the family or household's annual income in 1957. Organization

56

membership and regularity of attendance for the informant

was also provided for in the questionnaire. The remaining
questions dealt with age of the informant, status in the

family or household, number of children living at home, and
whether or not the informant provided the family or household's

chief means of support.

Pro-Test 2; the Questionnaire

The pre-testing of the questionnaire was conducted on a
specially drawn pro-test sample taken from the admittance
records of Mercy Hospital. The method of selection of the
pre-test sample was the same as the selection of informants
for the final study; the exception being that every tenth
patient number was selected until a total of twenty pre—test
informants had been drawn. A pro-test was conducted on twelve
of these for the purpose of assuring clarity and understanding
of the questions.

The results of the pre-test revealed that first, re-
spondents tended to equate the word 'publicity'with “adven-
tizing' so that in the final wording of the questionnaire
careful attention was given to defining “publicity“ in terms
of general information and news about local hospitals. The
pro-test also revealed that the respondents reacted to many
of the questions as though the interview was a test of their
knowledge, consequently producing a high number of ”don't know'
responses. It was determined, on the basis of the pre-test,
that informants should be led to believe that the question-

naire was not a test of knowledge, but rather that it

5?
constituted a method, on the part of the interviewer, of
learning about the kinds of publicity which had been released
in the previous year. In the final survey, the informant was
given the impression that the interviewer knew nothing of local
hospital publicity and that by questioning people about what
they had seen or heard, the interviewer would determine what
publicity had actually been released. This procedure was felt
to produce a greater number of useful 'yes' and "no“ responses.
Questions concerning the reception of hospital publicity were

then worded in terms of “have you ever...', rather than “do

you know if...'.
Characteristics p; the gap};

In completing the 100 interviews, a total of #3 informants
were drawn from the alternate sample list to replace informants
rejected from the master sample list. Of the #3 rejections
from the master sample list, more than half were rejected be-
cause of having moved their residence; so; had either moved
outside the city limits of Jackson or moved to another town.
Over 16% were rejected, (all from Foote) because of age
restrictions; 7% were too old and 9% were too young; llfl'were
rejected due to death and 9% because of having listed a false
address with the hospital so that they could not be located.
Slightly less than 6% were rejected due to mental problems
which precluded intelligible interviewing, and a final 2% re-
fused to be interviewed.

Of the 54% rejected because of moving, it was found that

58

60%.had lived in areas of the city which were industralized
or in areas immediately adjacent to industralized areas.
Normally high rates of mobility in such areas would tend to
account for the high rate of informant rejections from these
areas.

A total of 26 persons, whose residences in 1957 were in
industrial areas or adjacent to industrial areas, were rejected
from the master sample list for all reasons combined. Because
of high mobility in these areas it was only possible, in re-
placing the rejections, to obtain 17 informants from such
areas. As a consequence, the final sample contained 9 less
informants from industrial and semi-industrial areas than the
master sample would have provided.

The differencesin ages between those rejected from the
master sample and those replaced from the alternate sample
could only be tabulated for Mercy Hospital's representatives.
Foote Hospital did not record ages of patients in their ad-
mittance records. Nineteen of the 43 rejections represented
Mercy. In only 1 age category (36-40), was the difference
between the number of rejections and the number of replace-
ments as high as 3. In 2 age categories there was a total
difference of 2, and in 3 age categories there was a total
difference of l.

A total of 10 males and 33 females were rejected from
the master sample for all reasons combined. These were re-

placed by 11 males and 32 females.

DIFFERENCES BETWEEN REJECTED AND REPLACED
INFORMANTS BY AGE, SEX, AND RESIDENCE

TABLE 1

 

 

 

 

 

Number Number
Rejected Replaced Difference .
a
20 or less 2 l -1
2l - 25 a 6 2
26 - 3O 2 4 2
31 — 35 2 2 0
B6 -ihO 3 O -3
:1 l - 1.5 l l o
4 he — 5o 1 1 O
51 - 55 l l o
56 - 60 l 2 1
61 or more 2 l -1
g Males 10 ll 1
to Females 33' 32 -l
IsJIndustrial 13 7 -6
'3 c Semi-Indus. 13 lo -3
g." g Non-Indus. 17 26 9

 

 

 

 

 

aAge comparisons are for Mercy Hospital only.

The final sample included a total of 36 males and 6b

females, whose ages formed the following age-sex distri-

bution:

60

Figure 1

AGE — SEX DISTRIBUTION OF THE SAMPLE

 

 

min-lam; Asa imam
7 ///////( 61+ )/// 3
1 /(56 - 60)////// 6
3 ///(51 - 55)/// 3
h ////(h6 - 50)///// 5
6 //////(ul — #5)/ 1
4 ////(36 - h0)///////// 9
3 ///(31 - 35)//////////// 12
3 ///(2e _ 30)////////// 10
3 ///(21 - 25)////////////// in
3:2 MALES ”L 20. U m 75%

The apparent disproportionate number of women #0 years
(bf age and under is accounted for by the fact that over half
(Jr the women in this age group listed “maternity“ for at
ILeast one of their hospital admittances.

Nearly half of the informants, #8%, provided the family's
Ou'household's chief means of support. Of this number, 33
‘were male and 15 were female. The occupational distribution
of the providers of the family's or household's chief means
of support, along with the occupational distribution of the

informants is summarized in Table 2.

DISTRIBUTION OF OCCUPATIONS BY
CHIEF PROVIDERS AND INFORMANTS

61

TABLE 2

 

 

 

 

 

 

b IChIef
Occgpational Class Providers Inform;ntg_
Professional-Technical 12 6
Proprietors, Managers 6 3
Clerical Workers 6 8
Sales Workers 6 8
Craftsmen, Foreman 16 5
Operatives 33 14
Service Workers 7 12
Laborers 5 3
Pension, Welfare 8 6
Housewives 0 33
None Reported 1 2

 

 

bThis occupational classification is based on the one

used by the U.S. Census.

The two classes of "service workers“

have been combined; farm related occupations omitted; and

“housewives" included.

The educational distribution was tabulated for the pro—

vider of the family's or household's chief means of support

as well as for the informant.

marized in Table 3.

These distributions are sum-

62

TABLE 3

DISTRIBUTION OF EDUCATIONAL ACHIEVEMENT BY
CHIEF PROVIDERS AND INFORMANTS

 

 

Chief
Amount of Schooling. Providers Informants
Some Elementary School 9 6
Completed Elementary School 16 15
Some High School 29 32
Completed High School 28 33
Some College 10 12
Completed Four Years College 3 0
More than Four Years College h 2

 

 

 

 

 

The organization membership of the informants, when
tabulated, revealed that slightly less than a third of the
‘entire sample, 32%, belonged to no organizations at all. An-
other third, 31%, belonged to only one organization. Twelve
percent belonged to 2 organizations and another 12% belonged
to 3. Seven percent claimed membership in h organizations,
and 2% were members of five different organizations. Four
percent claimed membership in 6 or more organizations. None
belonged to more than 7 different organizations.

The total annual income for the family or household in

1957 was distributed as indicated in Table 4.

63

TABLE 4

DISTRIBUTION OF INCOMES OF EAMILI
OR HOUSEHOLD IN 1957

Income Number
h,000 or less . ......................... 16
4,001 - 6,000 . ........................ #7
6,001 - 8,000 . .............. ... ...... . 1h
‘8,001 - 10,000 . ....................... 12
10,001 - 12,000 . ...................... 1
12,001 - 15,000 ...................... . 0
15,001 - 20,000 .. ..................... 2
20,001 or more .. ...................... . 1
”Don't Know” ... ........ ... ............. . 6

Refused to Answer ... ..... . ..... . ...... .. 1

Analysis _o_f_ 3113 page;

Scoring pp Publicity Reception

Nine different questions regarding the reception of hospi-
tal publicity were evaluated to determine an index score for
the individual informant's reception. These items were con-
cerned with: (1) newspaper, (2) radio, (3) displays, (h)
literature, (5) speeches, (6) hOspital open-houses, (7) hospi-
tal sponsored dances, (8) women's auxiliary events, and (9)
the bond issue. The informant's responses to these items were
evaluated in terms of the specificity of the response, the
accuracy of the response, and in the case of items numbers 6
and 8, participation or attendance. Each item was scored
individually from O to 5, with 0 indicating no reception and
5 indicating greatest reception. A perfect reception score
would’then be #5.

Newspaper and radio reception were evaluated in terms of

the number of specific hospital topics the informant claimed

6b

to have read about or heard discussed. Display reception was
evaluated in terms of the number of displays seen and the lo-
cation of the displays. Reception of hospital literature was
evaluated in terms of the accuracy of the informant's re-
sponse.8 Reception of hospital speeches was evaluated in
terms of the informant's ability to specify the topics dis-
cussed. Reception of hospital open houses was evaluated in
terms of the informant's attendance and ability to specify

9

what was observed. Reception of hospital sponsored dances
was evaluated in terms of the accuracy of the response.10
Reception of women's auxiliary events was evaluated in terms
of attendance and ability to specify what occurred.11
Reception of information about Foote Hospital's bond issue was
evaluated in terms of the following criteria: (1) Accuracy

in acknowledging that a bond issue had occurred, (2) accuracy
in identifying the hospital involved, and (3) accuracy in
specifying the actual issues involved. The total number of

points received for each item was then added in order to

 

8This was possible because in all cases the actual re-
ception of literature was known excepting isolated communi-
cations, not of a publicity nature.

9Attendance was necessaryfor reception of publicity
distributed at an open house. Knowledge that open houses
were held was accounted for in newspaper and radio reception.

10This was possible because the actual occurrence of
hospital sponsored dances was known.

11Attendance was necessary for reception of publicity
distributed at such events. Knowledge that auxiliary events
had occurred was accounted for in newspaper and radio
reception.

arrive at the informant's total reception score.

The distribution of reception scores obtained in this
study, along with the final grouping of the scores for an
index of reception to be used in testing the hypotheses, is
indicated in Table 5, below.

TABLE 5

DISTRIBUTION OF HOSPITAL PUBLICITY
. RECEPTION SCORES

 

 

 

 

 

Reception Number of Number of
Score Informantg_Class Infonmants Composition
”1 - #5 points 0
be .. no 0
D1 - 35 I l
26 - 30 l 3 I. 18 16 — #5 points
' (High Reception)
F1—- 25 3
16 - 20 ll
11 - 15 11+
6 - 10 28 II. 82 1 - 15 points
(Low Reception)
1 - 5 E no
I

 

 

 

 

 

 

 

Socio-ggonomic Status Indices

Each of the four measures of socio—economic status used
in this study, has been ranked from highest to lowest. For
purposes of this study. the occupational status of the family
or household's chief provider has been used instead of the
occupational status of the informant. This has been done pri—

marily because the chief provider of a family sets the income

66

level which, in turn, determines the style of life for the
family. Also, a third of the informants interviewed, 33%.
claimed ”housewife“ as their own occupation. "Housewife,“
as an occupational class tells one nothing abOut the indivi-
dual's social status. '

The following table indicates the chief providers occu-
pational distribution, along with the occupational classes

used in testing the occupation hypothesis of this study.
TABLE 6

DISTRIBUTION OF CHIEF PROVIDERS OCCUPATIONS

 

Occupational Number Number
Groppp of Cases Class of Cases Composition .

 

Professional-Technical l2

Proprietors, Managers 6
I. 30 White Collar
Clerical Workers 6
Sales WOrkers 6
Craftsmen, Foreman 16
Operatives 33
Service WOrkers 7 II. 69 Blue Collar
Laborers

Pension—Welfare

 

 

 

 

 

 

 

The educational level of the informant has been divided
into three basic classes for the purpose of testing the edu-
cation hypothesis of this study. The distribution of informant's
educations and the classes used in this study is indicated in
Tabl e 7.

67

TABLE 7

DISTRIBUTION OF INFORMANTS

EDUCATIONAL LEVEL

 

 

  
    
 

Number of Number of

cunt of School. Informants Class Informantp Composition

re than h yrs.

College 2

ompleted A yrs.

College 0 1. In College

me College 12

ompleted High .

School 33 II. 65 High School
Some High School 32
ompleted Grammar

School 15 III. 21 Grammar School
ome Grammar

School 6

 

 

 

 

 

 

 

The informant's participation in local organizations has

been divided into three basic classes for the purpose of testing

the “organization“ hypothesis of this study.

The distribution

of informant's participation in local organization, along with

the classes used in this study, is indicated in Table 8.

TABLE 8

DISTRIBUTION OF INFORMANTS PARTICIPATION
IN LOCAL ORGANIZATIONS

 

 

 

 

 

 

 

Number of
Organization Number of Number of
Memberships Informants Class Informantp Composition ,
Five or More 6
I. 13 Four or More
Four 7
Three 12
II. 24 Two to Three
Two 12
One 31
III. ‘ 63 One or Less
None 32 1
l

 

 

 

68

For purposes of this study, the family or household's
total income for the year 1957 has been divided into two
broad classes. The distribution of family incomes, along with
the classes used in the test of the “income“ hypothesis, is
indicated in Table 9.

TABLE 9
DISTRIBUTION OF FAMILY OR HOUSEHOLD'S INCOMES

 

 

 

 

 

Number Number
ngome of Cases Class of Cases Copposition

20,001 or more 1

5,001 - 20,000 2
12,001 — 5,000 0
10,001 - 12,000 1

8,001 - 0,000 12

6,001 - 8,000 in I. 30 6,001 or more
b,001 - 6,000 #7 II. 63 6,000 or less
6,000 or less 16

 

 

 

 

Testing 9; the Hypotheses

The joint distribution of each of the above four measures
of socio-economic status, with the reception index,will be
presented. A chi-square test of association between the
reception of hospital publicity and each of the four measures
of socio-economic status will then be made. Rejection of
each null hypothesis will require a value of chi-square greater

than the chi-square for which P = .05.

CHAPTER III

FINDINGS

Test _3 he Hypothesis

 

A test of the general hypothesis (that among this sample
of former hospital patients, the reception of hospital publi-
city is associated with socio-ecOnomic status) will be ac-
complished by a chi-square test of association between re-
ception and each of the four measures of socio-economic status.
For purposes of this test, the reception scores have been
categorized into two general classes: Class I representing
"High Reception', and Class II representing "Low Reception".

A test of the first null hypothesis, involving the
association between reception and occupation, required a
collapsing of occupational categories into two general occu—
pational classes: White collar and blue collar. The joint
distribution of the two general classes of reception with the

two general classes of occupation. is indicated in Table 10.

TABLE 10
THE RECEPTION OF HOSPITAL PUBLICITY BY OCCUPATION

C

 

69

70

Since the chi-square value necessary to reject the hypo-
thesis that the reception of hospital publicity is not assoc-
iated with occupation is only 3.841, and the obtained value
of chi-square was 12.051, it is possible to reject the null
hypothesis. This data would, then, tend to indicate that
there is, in fact, an association between the reception of
hospital publicity and occupation.

In order to test the null hypothesis that there is no
association between the reception of hospital publicity and
income, it was necessary to collapse the categories of income
into two general classes: Those having incomes of $6,001 or
more, and those having incomes of $6,000 or less. The joint
distribution of the two general classes of reception with

the two general classes of income, is indicated in Table 11.
TABLE 11

THE RECEPTION OF HOSPITAL PUBLICITY BY INCOME

 

‘ v t w——v—

 

 

 

 

 

 

 

 

 

 

 

 

 

Income
Recepiion OLQng 756,001+- Tags;
. 9 9 1
Class I. (121 L 6)
5” '_v 21 73
Clas II. _ (51) {2&1 __
Total 63 .30 93
h x2 L2L8c;__lrgr.> .05

 

The chi-square value necessary to reject the null hypo-
thesis that there is no association between the reception of
hospital publicity and income is 3.8“1. Since the obtained
value of chi-square was only 2.801, it is impossible to re-

ject the hypothesis. Rather judgment will be reserved.

71

A chi—square test of association between the reception
of hospital publicity and education required a collapsing of
the educational categories into three basic groups: Those
having grammar school educations only, those having high
school educations and those having college educations. The
joint distribution of the two general classes of reception
with the three classes of education. is indicated in Table
12.

TABLE 12

THE RECEPTION OF HOSPITAL PUBLICITY
BY EDUCATION

 

 

 

 

 

 

 

 

Education - I
Reception G.S. H.S. 001, Total
(in) ,Lll ( 31
Class I. 1
21 5h 7 82
Class II. (12) _(5#1 QLLL
Tc ta], .3; 65 13 .1 0.0.. _..,

 

 

 

 

 

 

 

x2 ; 11.228, P5.Q§

 

Since the value of chi~square for which P = .05 is 5.991,
and the obtained value of chi-square was 11.728, it is possible
to reject the null hypothesis that there is no association
between the reception of hospital publicity and education.

The data would tend to strongly support the assertion that
there is, in fact, an association between these two variables.

The final working hypothesis to be tested states that
there is no association between the reception of hospital
publicity and participation in local organizations. In order
to test this hypothesis, it was necessary to collapse the

/‘

“72'
number of organizations into three basic groups: One or less,

2 to 3, and 4 or more. The joint distribution of the reception

of hospital publicity with participation in local organizations
is indicated in Table 13.

TABLE 13

THE RECEPTION OF HOSPITAL PUBLICITY
BY NUMBER OF ORGANIZATIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

Organiggpipns
One Or Two to r_‘Four or
Rece tion Less Three More To
*2. I r z: is. . a: ‘1'“:
ass . 1

66’ 18 E 82
Class II (52) (20) QLO) V
Total 63" 24 _gl3 100

x2 = 264%. P4.0fi

 

 

Since the value of chi-square necessary to reject the
hypothesis that there is no association between the reception
of hospital publicity and participation in local organizations
was 5.991, and the value for chi—square obtained was 26.548,
it is possible to reject the hypothesis. The data would sug-
gest that there is an association between the two variables.

[LTaken together, the three hypotheses which posited no
association between the reception of hospital publicity and
(1) occupation, (2) education, and (3) participation in local

4,, r“

organizations, were rejected.[This would tend to substantiate

p/
the general hypothesis that the reception of hospital publicity

f

is associated with measures of socio-economic statusLj Only

the inability to reject the hypothesis concerning reception

73

and income tend to discourage this conclusion.

It is possible that the failure of the income data to
coincide with the data obtained on the other three variables.
is indicative of a general difficulty in research to obtain
accurate information regarding what is considered by many
informants to be highly personal. While the question regard-
ing income was answered by 93% of the informants, it is
possible that the responses obtained were not valid.

Therefore, while it is not necessary to reject the general
hypothesis that there is an association between the reception
of hospital publicity and socio—economic status, it may be
advisable to revise the hypothesis in such a way as to ex—
clude ”income". On the basis of the findings of this study,
the hypothesis would then be: Among former hospital patients,
the reception of hospital publicity will be associated with
socio-economic status as measured by occupation, education,

and participation in local organizations.

Other Finding;

Reception and IncreasingSocio-gconomic Status

While no statistical test was made to determine if the
reception of hospital publicity tended to increase in the
direction of increasing socio—economic status, a brief exami-
nation of the data would suggest that this may, in fact, be
the case.

For example, in the case of reception and occupation,
61% of those having "high reception” were white collar as op-

;posed to 39% blue collar. Likewise, of those receiving'low

7n

receptiod‘scores, only 23% were white collar as opposed to more
than 76% blue collar. These percentages would strongly suggest
that the reception of hospital publicity tends to increase
among white collar workers.

In the case of education and reception, those informants
classed as having “high school" educations were found to have
more representatives in both “high reception" and “low
reception'I groups. However, those having college educations
accounted for nearly 39% of the "high reception“ group as
Opposed to only 8.5% of the ”low reception” group. Informants
of the grammer school group contributed none to the ”high
reception" group, but contributed over 25% to the “low
reception" group. Thus, it would also appear that the amount
of reception of hospital publicity tends to increase as one
achieves more education.

In the case of income and reception of hospital publi-
city, it was found that those informants receiving “high
reception“ scores were evenly distributed between the two
income groups. However, it was also found that those of the
lower income group contributed to nearly three-fourths of the
"low reception” group,while the higher income group contributed
only one-fourth of the "low reception“ group. While these
data do not permit a strong assertion that the reception of
hospital publicity tends to increase with greater income,
there is some evidence to indicate that this may be so.

The Joint distribution of the reception of hospital

Publicity with the number of local organizations in which the

75

informants claimed membership also tends to point out increas-
ing reception in the direction of greater participation with
local organizations. A full half of the informants belongingtm
four or more organizations received "high" reception scores
as opposed to only 5% having "low'I reception scores. Further,
nearly three-fourths of those informants with "low" reception
scores claimed membership in only 1 or no organizations.

[:ln each measurement of socio-economic status used in
this study, evidence was found which would suggest increasing
reception of hospital publicity in the direction of increasing
socio-economic status.i?These findings are highly compatable
with the findings of many mass communications researchers.
Lazarsfeld has repeatedly asserted that persons of relatively
higher socio-economic status, as measured by a number of
different indices, make more use of mass communications media
for public affairs information and are, generally, more in-
formed about public affairs issues than persons of lower

1 Wilber Schramm has likewise con-

socio—economic status.
tended that public affairs communications are more highly
utilized among persons with higher educations and generally

higher socio-cconomic status.2

Reception and Former Hospital Egperience
Returning, briefly, to the position taken by the public

 

relations minded hospital administrator, it will be recalled

that one of the assumptions on which his public relations

 

1See Lazarsfeld: 19h0, 19h8 and 1955.
2Wilber Schramm and David M. White, 92. cit., pp. 150-56.

76

scheme is premised is the assumption that the reception of
hospital publicity will be closely associated with former
hospital experiences. While this assumption has heretofore
been tacitly rejected as invalid, in this study, evidence may
be found in the data which would suggest that the rejection
of the assumption may have been well founded.

A series of chi—square tests of association between the
reception of hospital publicity and a number of measures of
hospital experience was made. The total results of the
statistical examination showed that null hypotheses concerning
the reception of hospital publicity and hospital experience
measures could not be rejected. The following table sum-

marizes the results.
TABLE lb

RESULTS OF CHI—SQUARE TESTS OF ASSOCIATION BETWEEN
THE RECEPTION OF HOSPITAL PUBLICITY AND
MEASURES OF HOSPITAL EXPERIENCE

 

Null mothesegi Finding;
The reception of hospital '
publicity will not be as- O tained Value Required for

 

 

 

sociated with: x Vglue Rejection at P2195
'Tfital number of patient
da s ingpast two years. l1h66 _5.991, P.>,05

 

 

 

otal number of family
admittances in past two
laser; JJZZ 1.815. P.>.05
Total number of times r"-
"ever been a hospital

 

 

 

 

 

 

 

atlent". 305:4 21511-5; P)oei
se or non-use of hospi—
..LaL1nsurance. 1.58;: 3.8a LP>.O§

 

It is evident that hypotheses stating an association

between the reception of hospital publicity and these measures

77

of hospital experience are not supported by the evidence.3

Summary gleindings

Chi—square tests of association between the reception of
hospital publicity and four measures of socio-economic status
were made. It was found possible to reject three null hypo-
theses which posited no relationship between the reception of
hospital publicity and (l) occupation, (2) education, and (3)
organization membership. The data did not permit a rejection
of the null hypothesis conserning reception and income. How—
ever, due to the possible invalidity of the income data, it
was felt that the general hypothesis,which states that there
is an association between the reception of hospital publicity
and measures of socio—economic status, could not be rejected.
The general hypothesis was then revised to state: Among
former hospital patients, the reception of hospital publicity
will be associated with socio—cconomic status as measured
by occupation, education, and participation in local organi-

zations.

[The data were found to support many mass communications
research findings which contend that the reception of public

affairs publicity tends to increase among relatively higher

socio-economic groups; {It was found that there was a general

3A number of other measures of fonmer hospital exper-
ience were obtained in this study, but found to be inappli-
cable to chi-square analysis. Other measures, involving the
informant's evaluation of hospital services and accommodations,
along with an evaluation of the total hospital experience,
were found to be constant.

78

tendency for greater reception of hospital publicity among
those with white collar jobs, higher educational levels,
greater incomes and membership in a greater number of organi-

\‘

zations. /

.—-I‘""

r“

[\The data obtained in this study also tended to discourage
the assumption made implicitly in the public relations minded
hospital administrator's public relations scheme, that the
reception of hospital publicity is associated with former
hospital experiences. A series of chi-square tests of null
hypotheses which declared no association between reception

of hospital publicity and some measures of hospital experience
indicated that such null hypotheses could not be rejected.

CHAPTER IV
CONCLUSIONS

Conclusions

On the basis of the findings presented in this study,
the generalZEonclusion may be drawn that the success_of mass
communications in reaching any diverse and heterogeneous
society with information of a public affairs nature is highly
limited? This would appear to be the case due to the distri-
bution of reception of public affairs publicity among the
members of the receiving audience. If mass communications
were to be a successful method of producing an informed and
educated “public,“ then the reception of communications de-
signed to achieve this result would have to be evenly distri-
buted among all segments of the "public“ or audience. As
the data have shown, this does not appear to be the case.
Rather, it has been shown that the reception of this type of
communication is not distributed evenly and is, in fact,
differentially received among the various strata of the re-
ceiving group so that there are “informed publics' and 'un-
informed publica.’

This conclusion follows from the finding that the
reception of hospital publicity, as a form of public affairs

information, is associated with socio—economic status as

79

80

measured by occupation, education, and participation in local
organizations. This finding is in strong agreement with the
findings of similar studies performed by such social scientists
as Lazarsfeldl, Starz, Bevillea, and Schrammu, only to mention
a few.

While no actual test was made in this study of the
relative reception of hospital publicity by increasing socio-
economic status, the data were strongly suggestive that
reception tended to increase with higher status positions.
This was true of all four measures used in the study. A
possible explanation of why this relationship would exist, in
the case of organization membership, might be found in the
purported influence of “direct communication contact.“ The
speeches received by organization members, in connection with
the Foote Hospital bond issue, would be an example of direct
communication contact. One writer, at least, has maintained
that this type of communication is the most powerful means
of communications yet devised and, as such, the reception of
a speech would enhance the individual's reception of
publicity.5 As membership in local organizations was a

criterion of socio-economic status, it might be expected that,

other things being equal, those persons belonging to

 

lPaul F. Lazarsfeld, 1940, p. 21. and Elihu Katz and
Paul F. Lazarsfeld, _p, cit., p. 274.

zdhirley Star and Helen M. Hughes, pp. cit., p. 397.
3s. M. Beville, Jr., 92. cit., pp. 202:.

“Wilber Schramm and David M. White, pp, cit., pp. 259ff.
SCharles S. Steinberg, pp, cit., p. 123.

81

organizations which received bond issue speeches would obtain
higher reception scores than those persons who did not belong
to such organizations, and hence a higher membership rating
would be related to higher reception scores.

In the case of the education criterion of socio-economic
status, a possible explanation of the suggested relationship
between higher status and higher reception might be found in
the purported ability of better educated people to better
express themselves. Lazarsfeld has claimed that:

Educated people can articulate their thoughts with

greater ease, they are better able to discriminate

between the different typeg of (content)..., and

they have wider interests.

If this is true, then it would be expected that persons having
more education would obtain higher reception scores than per-
sons with less education.

Further, if educational background is closely related
to occupation and income as is commonly held and justified by
studies of social class, then it could also be held that more
highly evaluated occupations and higher income groups would,
likewise, obtain higher reception scores. This was also
shown to be indicated by the data obtained in this study.

Another conclusion which can be made on the basis of the
findings presented in this study is that the reception of
public affairs publicity is not particularly dependent on
previous experience with the issues or public affairs involved.

That is, to say, in the context of hospital publicity, former

hospital experience does not appear to be an influential factor

 

bPaul F. Lazarsfeld and Patricia L. Kendall, pp. cit. ,
p. 20.

82

in association with the relative amount of reception of
publicity which the individual experiences. This conclusion
runs contrary to the assumptions suggested by the public re-
lations minded hospital administrator in that he would contend
that former hospital experience is the one crucial factor
which accounts for the reception of such publicity. Thus,
while no comparative test was made of reception between
former hospital patients and non-former hospital patients,
the data obtained using only former patients is seen to cast
serious doubt on the assumptions premising the public re-
lations minded hospital administrator's public relations
scheme.

Still another conclusion would follow from the data con-
cerning Wirth and Blumer's contentions regarding the unifi-
cation powers of mass communications. The amount of varia-
bility found in the reception scores of the informants would
seem to pose a question about the common basis of experience
provided by mass communications as imputed by Wirth and
Blumer. If a piece of communication is received in highly
differential amounts by different strata of a receiving
public, then there would appear to be little common basis of
experience between the strata. Likewise, regardless of the
potential exposure to a piece of communication, little common
basis of experience would result between those who fully
received the communication and those who failed to receive it
altogether. As the data obtained in this study, along with
findings of many similar studies, did, in fact, indicate

83

differential reception,the contention that mass communi-
cations act as a unification force and a concensus producing
agent is held to be in serious doubt.

One final conclusion may be drawn concerning the
potential use of the findings of this study by those most
directly concerned; first, public relations minded hospital
administrators, and second, social scientists.

The public relations minded hospital administrator would
find this study of comparatively little value. Public re-
lations men, in general, have chosen to neglect the findings
of mass communications research regardless of findings which
contest their position. Part of the reason for this is found
in the pragmatic orientation of public relations itself.

That is, public relations practices, including the use of
mass communications, are applied for specific purposes such

as the increasing of sales, the development of rapport between
management and labor groups, or, in the case used in this
study, the passing of a bond issue by public vote. The mea-
sure of success of the public relations practices is the
success or failure in achieving the desired goal. As one
writer in public relations state it:

The communication process, from a functional viewpoint,

illustrates one aspect of the philosophy ofpuagmatism.

An act of communication, generated for reasons of

influencing public opinion, is successful if it

accomplishes the original public relations objegtive

of motivating public opinion to some overt act.

Thus, the success of the mass media campaign in Jackson

for the passing of a bond issue was measured in terms of

v

7Charles S. Steinberg, 9p. cit., p. 23.

8h

whether or not the bond issue passed or was voted down. In
this case the bond issue passed. This would lead the public
relations man and the hospital administrator to regard the
campaign as a successful use of mass communications, thereby
imputing validity to the assumptions regarding mass communi-
cations on which the campaign was premised. Although the ree
suits of this study have indicated that these assumptions are
for the most part false, the public relations man and the
hospital administrator are satisfied because the original
purpose was accomplished.

The social scientist, on the other hand, would regard
the findings of this study in quite a different light. The
sociologist, interested in mass communications, is primarily
concerned with the gaining of knowledge relative to the
nature, dynamics, and effects of mass communications rather
than with the specific practical results achieved by those
who employ the media.

Having this orientation towards mass communications,
the sociologist would consider the findings of this report
to be of value in that they provide for the additional sup-
port of findings obtained in other similar studies dealing
with public affairs publicity. The replication of findings
which have resulted from studies in a number of contextual
areas serves to strengthen the knowledge about the general
field of interest. Additional confirmation. of the validity
of the findings is obtained. As such, the sociologist would
regard this study as a contribution to knowledge about the

general field of mass communications in that it has shown a

85

general proposition (the reception of public affairs publicity
is associated with socio-economic status) to be supported in

a new context of study.

Implicaplons p; the Findings
The important implications provided by the findings of

 

this study would seem to apply to an area outside of the con-
text of hospital public relations. The study has provided
findings corroborating other research findings which have
indicated that mass communications fail to provide for
unified action or consensus. This being the case, it would
appear that such findings pose some serious questions re—
garding the democratic society.

The importance of an intelligent and informed body of
voters to a democratic society cannot be disputed. Democracy
is premised on the participation of the members of a society
in the government through the use of their vote. However,
when the democratic society becomes characterized by hetero-
geneity, large numbers of peeple and the other criteria which
indicate that the society is becoming similar to Wirth's
”mass,” then it becomes increasingly difficult to obtain the
necessary intelligent and informed body of voters. The members
of the society become sufficiently separated from the affairs
of state that knowledge of such affairs and participation in
the government becomes increasingly remote. In order to
develop and maintain closer relationships between the members
of the democratic society and the government mass communi-

cations are used. It is believed that mass communications

86

will help to inform and educate the voting members of society
to the public affairs and issues of government.

The findings of this study, together with the findings
of many other studies dealing with the reception of communi-
cations of a public affairs nature, indicate that public
affairs communications are not received by the members of
the lower socio-economic groups to as great an extent as by
the members of the higher strata. As the members of the
lower socio-economic groups comprise the bulk of the popu-
lation in this democratic society, one would have to conclude
that mass communications are ineffective as a means of bring-
ing about an informed and educated voting body. The basic
conditions of democracy are, therefore, seen to be unfulfilled
to some extent. As long as public affairs communications re-
main the only means of attempting to obtain the necessary in-
formed and educated voting body, the great majority of
potential voters will remain uninformed and uneducated.

In consideration of the fact that mass communications
are the only plausible means yet devised for the dissemination
of public affairs information, together with the consideration
that these means are for the most part ineffective, one might
well assert that the general field of mass communications
demands considerable more attention from social science. It
would appear that we need to know a great deal more about
the dynamics of mass communications reception.

Various writers in the social sciences have contributed
research findings indicating factors associated with the

reception of mass communications other than socio-economic

8?

status. As yet, these other factors, together with the
general field of knowledge about mass communications, have
not been integrated into a theory which is adequate in explain-
ing the dynamics of mass communications reception. Both
Lazarsfeld and Star have submitted the suggestion that the
individual's 'predisposition'toward an issue may determine
' the extent of reception of communications regarding the
issue.8 Steinberg suggests that the individual's access to
the medium of communication determines reception.9 Bernard
Berelson has claimed that “personalism” effects reception.mo
He would submit that the more personalized the approach is,
the more effective it will be. Douglas Naples believes that
the two factors which account for both the exposure to and
reception of written materials are: First, accessibility to
the materials and, second, the readability of the materials.11
Thus, social scientists have contributed knowledge about
factors associated with the reception of mass communications
and this knowledge is of great value. However, it is perhaps
due to the failure of social science to produce a well inte-
grated theory about mass communications that practical steps

have not been taken to produce more effective means of

 

8Paul F. Lazarsfeld, 1942, p. 68, and Shirly Star and
Helen M. Hughes, 92, cit., p. 398.

9Charles S. Steinberg, PhD., 92, cit., p. 126.

10Bernard Berelson, 1950, pp. bSlf.

11Douglas waples, "The Relation of Subject Interest to
Actual Reading," Reader lg Pub ic Opinion and Communication,
ed. Bernard Berelson and Morris anowitz, Talencoe:'_The
Free Press, 1950) p. 351.

 

 

88

reaching the voters of this democratic society with the in-
formation necessary to intelligent, informed participation

in public affairs.

Limitation; g; the My

This study was not performed without its limitations.

The study and its results should be evaluated with the follow-
ing shortcomings in view.

In the collection of the data, two particular limitations
were cited. First, the information obtained regarding former
hospital experiences was not as complete and detailed as
might have been desirable. A more adequate test of the
public relations minded hospital administrator's assumptions
regarding former hospital experience and publicity reception
would demand considerably more information than was obtained
for this study. What information was obtained was limited,
for the most part, to the objective factors of admittances,
purposes, expenses, etc. While some attempt was made to ob-
tain former experience information of a more subjective
nature, such as the informant's evaluation of services and
accommodations, favorable or non-favorable impressions of
persons encountered in the hospital, etc., no adequate measure
of the subjective experiences can be claimed. More precise
data along these lines may have produced considerably
different results in terms of the association between
hospital experience and publicity reception.

Another shortcoming in the collection of data was the

failure to provide for a more adequate measure of exposure

89

to hospital publicity sources. What information was obtained
regarding "exposure" was limited, for the most part, to mea-
sures of the informant's ”potential exposure.‘I That is,
information was obtained relative to the subscription or non-
subscription to the local newspaper, listening or non-listening
to local radio stations, and extent of participation in local
organizations. These sources of communication provide only
for the potential exposure to items dealing with hospital
affairs, but they do not account for the probability of the
informant's selecting these items for consideration and at-
tention. A more adequate approach to the question of eXposure
would have provided for a measure of the informant's likeli-
hood of selecting hospital publicity for consideration as
Opposed to other tapics of information.

Three particular methodological problems are also cited.
The first of these involves the length of time between the
release of the hospital publicity in 1957 and the survey of
reception of the publicity in 1958. Ideally, the survey would
have been taken immediately after the bond issue campaign was
completed. However, as somewhat more than a year had elapsed
at the time of the survey, the possibility of forgetting may
have distorted the responses connected with the bond issue

12

questions. If this had, in fact, occurred the received

reception scores would have been lower than at the time of

 

12An individual known personally to the writer was heard
discussing the bond issue in detail at the time of the campaign
in 1957. At the time of the survey, however, this person could
recall only that a bond issue had occurred and that it involved
Foote Hospital.

90

the bond issue campaign. This would, in turn, raise some
questions regarding the relation of forgetting about the bond
issue publicity to socio-economic status. At the present,
these questions must go unanswered.

Another methodological limitation is cited in connection
with the scoring system employed in evaluation of hospital
publicity reception. Each of the nine publicity items were
rated on a scale from zero to five in the direction of in-
creasing reception. The individual scores for each item were
then totaled for the informant's reception score. This system
of scoring reception involves the assumption of intra-item
equality in that all publicity items were assumed to be of
equal importance as either a form of communication or a con-
tent area. That this may not have been, in fact, the case
was not determined. A more refined system for the scoring
of reception may have produced more valid reception scores.

A final limitation to the study is cited in the neces-
sity of collapsing many of the measurement categories used
for both the reception index and the four indices of socio-
economic status. In order to render the data amenable to
the chi-square test of association a great deal of information
was necessarily sacrificed. It was necessary to dichotomize
the various occupational categories as well as the income
groups. Likewise, the reception index had to be dichotomized.
As a result, much of the information was lost. The collapsing
of categories was a necessity because of the small numbers

of cases obtained for many of the categories. A larger sample

91
would have provided more satisfactory results.

Suggestiong £2; Further Research

In order to more fully investigate the question of
reception of public affairs communications, specifically with—
in the context of hospital publicity, two suggestions for
additional research are submitted. First, it would seem to
be of some value to more thoroughly investigate the possible
relationship of an individual's'subjective evaluation of
hospital experiences to the reception of hospital publicity.
This particular aspect of former hospital experience was not
adequately provided for in this study so that, at the present,
no conclusions can be drawn regarding what might be termed
“patient attitudes” and hospital publicity reception. It is,
therefore, suggested that methods for obtaining information
from former hospital patients regarding their subjective
evaluations of hospital experience be devised in order to
examine the influence, if any, of this factor on hospital
publicity reception.

A second suggestion for additional research within the
context of hospitals would involve a more thorough analysis
of the relationship between hospital publicity reception and
socio-economic status in terms of the direction and intensity
of the relationship. That is to say, it would seem to be of
value to determine more precisely the strength of relation-
ships at each level of socio-economic status. This would
involve a more powerful statistical examination of the data

and would eliminate the problem of sacrificing data as was

92

the case with chi-square.

In view of our present state of knowledge regarding mass
communications reception, two suggestions for additional re—
search in this general area are submitted. First, it would
seem to be of value to provide for additional research which
would account for some of the other factors found to be
associated with the reception of mass communications by other
researchers. Studies involving the factors of personalism,
accessibility, predisposition, etc., along with socio—
economic status might provide for a firmer basis of theory
formulation.

Finally, along the lines of the practical problems in—
volved in reaching members of lower socio-economic groups
with public affairs information, it would seem to be of
value to provide for additional research which would indi-
cate more effective methods of communication. Additional
studies, such as those performed by Katz and Lazarsfeld and
reported in Personal Influence13 which involve the flow of
communication or the lines of communication travel among all
those who receive a piece of communication, might indicate
more satisfactory methods of disseminating public affairs
information or point out the problem areas which hinder the

flow of communication.

 

— '-

13Elihu Katz and Paul F. Lazarsfeld, _p. cit.

BIBLIOGRAPHY
Books

Berelson, Bernard and Janowitz, Morris (ed.). Reader in Public
Opinion and Communication. Glencoe: The Free Press, 1950.

Block, Lguis, Dr. Hospital Trendg. Chicago: Hospital Topics,
195 .

Harlow, Rex F. and Black, Marvin M. Practica;_Public Relations.
New York: Harper and Brothers, 1952.

Harlow, Rex F. Social Science lg Public Relations. New York:
Harper and Brothers, 1957.

Janowitz, Morris. The Community Press in__g Urban Setting.
Glencoe: The Free Press, 1952.

Katz, Elihu and Lazarsfeld, Paul F. Personal Influence. Glencoe:
The Free Press, 1955.

Lazarsfeld, Paul F. Radio and the Printed Pag . New York: Duell,
Sloan and Pearce, l9h0.

Lazarsfeld, Paul F. and Kendall, Patricia L. Radio Eistening
‘ig America. New York: Prentice—Hall, Inc., 19“ .

Lesly, Philip (ed.). Public Relations Handbook. New York:
Prentice-Hall, Inc., 1950.

Meany, Anthony B. Radio-IE: Perils £2_Progperitx. New York:
Pageant Press, 1955.

Mills, Alden B. Hospital Public Relations. Chicago: Physician
Record Company, 1939.

Siepmann, Charles S. Radio's Second Chance. Boston: Little,
Brown and Company, 1955.

Steinberg, Charles 8., Ph.D. The Mass ngmunicators: Public

Relations, Ppblic O inion, and Mass Media. New York:
Harper and Brothers, 1958.

93

94

Waller, Judith C. Radio-—The Fifth Estate. Boston: Houghton
Mifflin Company, 1946.

Waples, Douglas (ed.). Print, Radio and Film in a Democracy.

Chicago: The University of Chicago Press, 1942.

Articles

Allport, Gordon E. and Faden, Janet M. “The Psychology of
Newspapers; Five Tentative Laws," Public Opinion
Quarterly, (December, 1940).

Barth, Allen H. and Griffiths Thomas D. "You - The Ambassador,“
Hospitals, (August, 1958).

Berelson, Bernard. “Communication and Public Opinion,“ Reader
;3 Public Opinion and Communication. Edited by Bernard
Berelson and Morris Janowitz. Glencoe: The Free Press,
1950.

Berelson, Bernard. ”The Effects of Print Upon Public Opinion,"
Print, Radio and Film in a Democracy. Edited by Douglas

Waples. Chicago: The University of Chicago Press, 1942.

Beville, H. M. Jr. “The ABCDs of Radio Audiences,“ Public
Opinion Quarterly, (June, 1940). '

Blumer, Herbert. “The Mass, The Public, and Public Opinion,"
Readep_ip Public Opinion and Communication. Edited by
Bernard Berelson and Morris Janowitz. Glencoe: The Free
Press, 1950.

Borowski, Anthony J. IPublic Relations Check-List for Adminis-
trators,“ Hospitalg, (February, 1958).

Brown, Ray E. "Hospital Professional Relations,‘I Hogpitals,
(January, 1957).

Freidson, Eliot. “Communications Research and the Concept of
the Mass,” American Sociologigg; Review, (June, 1953).

 

Gleiser, Fern W. "We Help Train Dietitians to be Managers,"
Hospitalg, (May, 1958).

Haver, Harry T. and Lateham, John F. ”Roll Out the Red Carpet,"
Hospitals, (November, 1956).

Knouth, Victor W. "Low Pressure - High Results," Hospitals,
(October, 1956).

 

95

Laetz, E. C. "Give the Public a Package They Understand,"
Heepitals, (September, 1957).

Lazarsfeld, Paul F. "Audience Research,“ Rpader ip_Public
Opinion and_gommunication. Edited by Bernard Berelson

and Morris Janowitz. Glencoe: The Free Press, 1950.

Lazarsfeld, Paul F. “The Effects of Radio on Public Opinion,“
Print, Radio and Film ip p Democracy. Edited by Douglas
Waples._Chicago: The University of Chicago Press, 1942.

Lesly, Philip. “Exactly What is Public Relations,“ Publlg
Relatiopp Handbook. Edited by Philip Lesly. New York:
Prentice-Hall, Inc., 1950.

Mueller, Douglas. “The Substance of a Public Relations Program,‘I
Trustee, (February, 1958).

Price, Delbert L. and Kinzer, David. “Cooperation is the Key
of New Chicago Hospital Press Code,‘I Hospitals,
(February, 1957).

Priver, Julian. “Twenty Ways Our Women's Auxiliary Polishes
Hospital Service,“ Hospitals, (August, 1956).

Read, Regard K. “A Hospital Goes to a Fair,“ Hospitapp, (May,
195 .

Schramm, Wilber. “The Nature of News," Journalism Quarterly,
(September, 1949). ’

 

Schramm, Wilber and White, David M. "Age, Education, Economic
Status: Factors in Newspaper Reading,” Journglism
. guartgply, (June, 1949).

Star, Shirley and Hughes, Helen M. “Report on an Educational
Campaign: Cincinnati Plan for the United Nations,“
American Journal 9; Sociology, (January, 1950).

Swanson, Charles E. “What They Read in 130 Daily Newspapers,"
qurnglism Qparterly, (Fall, 1955).

Welsh, D. W. ”Let the Patient Know What He's Paying For,“
Hospitals, (April, 1957). .

Waples, Douglas. ”The Relation of Subject Interest to Actual
Reading,“ Reader ip Public Opinion ppd_Communication.
Edited by Bernard Berelson and Morris Janowitz. Glencoe:
The Free Press, 1950.

Williamson, Kenneth. "The Hospital and Government,“ Hospitals,
(April, 1957).

Wirth, Louis. "Consensus and Mass Communication," American
Sociological_Review, (February, 1948).

 

96

Woody, Kennerly. “Telling is the Key to Selling,” Hospitals,
(December, 1957).

Reports and Unpublished Materials

Sagendorph, Kent. “Help Your Hospital Campaign,‘I Unpublished
paper, Jackson, Michigan, 1957.

W. A. Foote Memorial Hospital. Statistical Repoppiggp the
Fiscal Years l948-49 Through 1932-58. Jackson: H. A.
Foote Memorial Hospital, 1958.

Schedule No. Date ___

APPENDIX’

Reception 91 Hospit l Publicppy

Hospital Ezposure

1.

Have you or any member of your family ever been a hospital
patient?

0 - Yes, self only 3 - No
1 - Yes, others 4 - Don't know
2 - Yes, self and others 9 — No response

About how many times would you say that you have been a
patient in a hospital? times.

Most of the information that we're interested in concerns
only the past two years or so, say from the beginning of

1957. So now I'd like to ask you the same two questions

again; only this time we are only interested in the past

two years. Have you or any member of your family been a

hospital patient within the past year or two?

0 - Yes, self only 3 - No
1 - Yes, others 4 - Don't know
2 - Yes, self and others 9 - No response

a) About how many times would you say that you have been
admitted to a hospital during the past two years?

times.

b) How many times have other members of your family been
admitted to a hospital as patients within the past two
years? _ times.

c) Total family admittances during past two years.

(Complete the following for each admittance of the informant.)

50

I'd like to get a little detail now if I could on your own
hospital experiences since the beginning of 1957. (Start-
ing with your earliest admittance in that year), can you
recall the month and year that you were in the hospital?

 

 

“Irrelevant questions have been omitted.

97

10.

11.

18.

19.

20.

98

What was the general purpose of your being in the
hospital on that occasion?

0 - Surgery 4 - Maternity
l - Diagnosis 5 - Other (write in)
2 - Medication 6 - Don't know
3 - Isolation 9 - No response
What hospital were you in?
0 - Foote 4 - T. B. San.
l — Mercy 5 - University Hospital
2 — Osteo. 6 - Other (write in)
3 - St. Paul's 9 — No response

Approximately how long were you in the hospital on that
occasion?

Over night only

0 - 5 - Five days

1 - One day 6 - Six days

2 - Two days 7 - Seven days

3 - Three days 8 — More than one week
4 - Four days 9 - No response

Can you recall approximately what the cost was for this
hospital service?

0 - 25 or 1688 5 - 126 - £150
1 — 26 - 50 6 - 51 - 175
2 - 51 - $75 7 - 176 - 200
3 - 76 - 100 8 — 201 or more
4 - 101 - $125 9 - No response

Did you have any hospital insurance that helped pay the
cost?

0 - Yes 3 - Don't know
1 - Yes, but did not help 9 - No response
2 - No

Thinking back over your experiences in the hospital these
past two years, who would you say made the greatest im-
pression on you while you were a patient?

 

Would you tell me some of the things about the different
services and accommodations that the hospital(s) offered
that you feel you were most satisfied with?

 

Would you tell about some of the services and accommo-
dations that the hospital(s) offered that you feel you
were most dissatisfied with?

 

vmflfl

Have any of your friends or relatives been a patient in
a hospital within the past year or two?

99
O - Yes 2 — Don't know
1 - No 9 - No response

21. (If "yes“ to #20:) Do you know what services and
accommodations they were most satisfied with?

 

22. Do you know what services and accommodations they were
most dissatisfied with?

 

23. (If anything is listed in #22:) Do you think that their
criticisms are justified?

 

Exposure pg Hospital Publicity:

24. Have you ever been a member of any group or organization
that helps out or gives services to a hospital?

0 - Yes 2 — Don't know
1 - No 9 - No response

(If "yes“, what is the name of the organization?)
25. Do you know of any friends or relatives that do?

0 - Yes 2 — Don't know
1 - No 9 - No response

26. (If “yes” to #25:) Who is that?

0 - Family member 3 - Knows someone who does,
1 - Other relative but can't remember who
2 - Friend . 4 - Don't know

9 - No response

27. (If “yes" to #25:) Does this person often talk to you
about his (her) hospital affairs?

0 — Yes 9 — No response
1 — No

Part of what we are trying to do is to find out what
kinds of publicity programs that a community's hospitals have
carried out in the past year or so. We have listed some of
the types of publicity and ways of getting publicity out to
the people in a community that hospitals sometimes use. What
I'd like to do now is find out from you which of these you
have heard about or seen in Jackson. This will give us a
pretty good idea of what Jackson is doing in hospital
publicity.

28. We have found that most community newspapers print
articles or stories from time to time about their local
hospitals. Have you read any in the Jackson paper with-
in the past year or two?

100
0 - Yes 2 - Don't know
1 — No 9 - No response

If “yes": b) Can you remember which of the hospitals
you read about? '

1 - Mercy 5 - University Hosp.
2 - Osteo. 6 - Others (write in)-___

3 - St. Paul's 9 No response

c) Could you tell me what any of the articles
you read were about?

 

29. Quite often a community's radio stations will broadcast
information about local hospitals. Have you heard any-
thing about hospitals over your radio within the past
two years?

0 — Yes 2 - Don't know
1 - No 9 - No response

If "yes“: b) Can you remember which of the hospitals
you heard about?

0 - Foote 4 — T. B. Sen.

1 - Mercy 5 - University Hosp.

2 - Osteo 6 - Other (write in)___
3 - St. Paul's 9 - Don't know

0) Could you tell me what any of the broad-
casts you heard were about?

 

30. Sometimes hospitals will put up displays around town such
as hospital equipment or posters or things that patients
made. Have you seen anything of this sort in Jackson
during the past year or so?

0 - Yes 2 - Don't know
1 - No 9 - No response

If “yes”: b) Can you remember which of the hospitals it
was that put up the displays?

0 - Foote 5 - University Hosp.

1 - Mercy 6 - Other (write in)___
2 - Osteo 7 - Don't know

3 - St. Paul's 9 - No response

’4‘ - To B. Ban.

0) Can you remember what any of the displays
were?

 

d) Can you remember where it was that you
saw them?

 

31.

32.

3a.

101

In some communities the hospitals like to keep in touch
with the public by sending out or distributing literature
about their hospitals. Have you read or received any
literature about a Jackson hospital within the past two
years?

0 - Yes 2 - Don't know
1 - No 9 - No response

If ”yes": b) Can you remember from which of the hospi-
tals you received the literature?

0 - Foote 5 - University Hosp.

1 - Mercy 6 - Other (write in)_“_
2 - Osteo 7 — Don't know

3 - St. Paul's 9 - No response

4 - T.B. San

c) Can you tell me what any of the literature
was about?

 

d) Can you remember how you received the
literature?

 

Information about local hospitals is sometimes given at
organization or club meetings. Have you attended a
meeting during the past two years at which somebody
spoke about one of the Jackson hospitals?

0 - Yes 2 - Don't know
1 - No 9 - No response

If "yes“: b) What meeting was that?

 

0) Which of the hospitals were discussed?

0 - Foote 5 - University Hosp.

1 - Mercy 6 - Other (Write in)__fl
2 - Osteo 7 - Don't know

3 - St. Paul's 9 - No response

4 — T.B. San

d) Could you tell me what any of the speeches
were about?

 

Sometimes hospitals will hold an “open house“ for anybody
who wants to visit the hospital. Have you attended a
hospital "Open house“ within the past year or so?

0 - Yes 2 - Don't know
1 — No 9 - No response

If “yes": b) Can you tell me which of the hospitals here
in Jackson you visited during “Open house”?

36.

37.

39.

102

O - Foote 5 - University Hosp.

1 - Mercy 6 - Other (write in)___,
2 - Osteo 7 - Don't know

3 - St. Paul's 9 — No response

4 - T.B. San

c) What did you see at the ”open house“?____

d) Can you remember how you happened to know
that there was going to be an open house?

 

Some hospitals held an annual dance in order to raise
money. Does any Jackson hospital do that?

O - Yes 2 - Don't know
1 - No 9 - No response

If “yes“: b) Do you know which hospital that might be?

0 - Foote 5 — University Hosp.

1 - Mercy 6 - Other (write in)_w_
2 - Osteo 7 - Don't know

3 - St. Paul's 9 - No response

1" " T030 88“

0) Could you tell me what they call the
dance?__

—-

Have you attended any event sponsored by a hospital
woman's auxiliary during the past two years?

0 - Yes 2 - Don't know
1 - No 9 - No response

If yes: b) Which hospital's woman's auxiliary was that?

0 - Foote 5 - University Hosp.

1 - Mercy 6 - Other (write in)___
2 - Osteo 7 - Don't know

3 - St. Paul's 9 - No response

4 — T. B. Sen.

0) Can you tell me what the event was?

In many towns hospitals have been forced to put up bond
issues for public vote in order to finance various

hospital projects. Has any Jackson hospital done this
within the past year or so?

0 - Yes 2 - Don't know
1 - No 9 - No response

If "yes": b) Can you tell me which hospital it was?

103

0 - Foote 5 - University Hosp.

1 - Mercy 6 - Other (write in)___
2 - Osteo 7 - Don't know

3 - St. Paul's 9 - No response

4 - T.B. San.

c) Do you know how many proposals were to be
voted on?

 

d) Could you tell me what the bond issue
(proposals) was (were) about?

 

e) Do you recall when the election was

 

held? 1;
f) Did you happen to vote in that particular
election?
0 - Yes 2 - Don't remember
1 - No 9 - No response

g) Did the bond issue pass or not?

0 - Passed 2 - Don't remember
1 ~ Did not pass 9 - No response

h) Would you mind telling me how you voted
in that election?

0 - Voted for 3 - Refused to answer

1 - Voted against 9 - No response
2 - Don't remember

General Ipformation:

43. Informant:

O - Husband 2 - Other (write in)
l - Wife '

44. Occupation: a) Where do you (does your husband) work?

 

What kind of work does he do?

 

b) Is he (are you) currently employed?

0 - Yes 2 - Don't know
1 - No 9 - No response

c) Does the wife (or female head) work out-
side the home?

0 - Yes 2 - Don't know
1 - No 9 - No response

104

d) (If ”yes") What kind of work does she
do?

 

e) (If informant is other than male or female
head) Where do you work?

 

What kind of work do you do?

 

45. Age: WOuld you mind giving me your approximate age?

0 - 20 or under 6 - 46-50
1 - 21-25 7 - 51-55
2 - 26—30 8 — 56—60
3 - 31-35 9 - 61-65
9 - 36-40 X - Refused to answer
5 - 41-45
46. Size of household: a) How many members of the family

are living at home?

 

b) (If applicablesz) What are the
ages of the children?

A...—

0) Are there any others living in
the home who are not immediate
relatives of the family?

0 - Yes 9 - No response
1 - No -

d) (If “yes”: ) What is the relation—
ship and age?

 

47. a) Where did your husband (you) go to school?
What was the last grade or year that he (you)

completed?

0 ~ Some elementary 6 - More than 4 yrs. of
1 - Completed elementary college

2 — Some high school 7 - Don't know

3 - Completed high school 8 - None

4 — Some college 9 - No response

5 — Completed college

b) (If informant is not male head) Where did you go
to school?

 

m-q.— -

 

 

 

‘uga-O

What was the last grade or year that you completed?

Some elementary 5 - Completed college
Completed elementary 6 More than 4 yrs. of
Some high school college
Completed high school 7 - Don't know
Some college 8 — None
9 No response

thHO
lilll

105

48. Length of residence: How long has the family been a
resident of Jackson?

0 - Less than one year 5 ~ 9-10

1 - 1-2 6 - 11 or more
2 — 3—4 7 - Don't know
3 - 5-6 9 - No response
u-m

49. Do you now subscribe to the local Jackson newspaper?

 

O - Yes 2 - Don't know
1 - No 9 - No response
Approximately how long have you been subscribing to
it? “_
50. a) Do you have a radio in your home?
0 - Yes 2 - Don't know
1 - No 9 - No response
b) About how often would you say that you listen to it?
0 - Every day 4 - Less than once a
1 - Once every two or week
three days 5 ~ Never
2 - Once every four or 6 — Don't know
five days 9 - No response
3 - Once a week
c) What stations do you ordinarily listen to?
0 - WIBM 3 - “All of them"
1 - SKHM 4 - Don't know
2 - None local 9 - No response
51. a) One of the last things we would like to know is what

organizations you are a member of and your activities
in these organizations. To help you recall, we have
classified organizations into some different areas.
Do you belong to any local business or professional
associations such as the Chamber of Commerce,
Businessmen's Associations, the Board of Realtors,
Management or Labor organizations, or similar organi-
zations or associations?

 

 

( Do you attend
Have you held regularly or
Name of Length of any office in not? (Reg.)
Organization Membership est 2 yrgg, (Irreg.)

“

 

 

 

 

 

 

51.

51.

51.

51.

51.

106

b) Do you belong to any service clubs, such as Rotary,
Kiwanis, Lions, or Junior Chamber of Commerce?

e)

d)

e)

f)

 

Name of
Organization

Length of
Membership,

Have you held
any office in
est 2 yrg.w

 

 

 

 

Do you attend
regularly or
not?

 

Are you presently associated with any civic or welfare
organizations, such as the Community Chest, YMCA,
YWCA, hospital boards, PTA, Boy or Girl Scouts; and
public health organizations, such as TB Association,
American Cancer Society, etc.?

 

Name of
Organizption

 

Length of
Membershi

HavEyou held
any office in
pastggfyrs.

Do you atte—n-CT
regularly or
not?

 

 

 

 

 

 

 

 

 

 

Are you associated with any political or governmental
activity such as City Council, Board of Education,
any political party committees, or other organization
of that nature?

'— —"— Have you held Do you attend
Name of Length of any office in regularly or
Organigppion Membership past 2 yrg. not?

Do you belong to any fraternal, social, or religous

organizations such as the Masons, Elks, any women's
clubs, or church groups or other similar activity?

 

Name of
Organization

 

Length of

Have you held
any office in

Membership1 past 2 yrs;_

 

 

Do you attend
regularly or
not?

 

Is there any organization or group that you belong to
which isn't included in these categories that I've

mentioned?

0 — Yes
1 - No

(If “yes":)

2 — Don't know
9 — No response

 

Name of
Organipation

Length of
Membership,

Have you held
any office in

,past 2 yrs.

 

 

 

 

Do you attend
regularly or
not?

 

107

One last item and I'll be on my way. You have been very
cooperative and I want to thank you for that. I'd like
you to look at this card which lists different groupings
of family incomes. You can see that they are quite broad
categories. would you please tell me the number next to
the grouping in which you think your last year's income
fell? (To be listed on the card.)

 

(Not to be listed on card:)

8 ~ Don't know
9 - No response

BELOW IS A COPY OF
THE INCOME CARD USED

 

MICHIGAN STATE UNIVERSITY
Department of Sociology and Anthropology

 

_ CONFIDENTIQL —
0- 4,000 or less 4- 0,001 - 12,000
1- 4,001 - 0,000 5- 2,001 - 15,000
2- 6,001 - 8,000 6— 15,001 - 20,000
3— 8,001 —

10,000 7-320,001 or more

 

 

 

MICHIGAN STATE UNIVERSITY

JIUII I!!! nu

3 1293

3071 34

L BRARIES
69