Production and Dissemination Costs for Developing a Brief Video-Based Intervention Designed for Patients in Clinic Waiting Rooms: Safe in the City

Background: Safe in the City (SITC) is a 23-minute video intervention on DVD that includes three vignettes depicting couples in situations that require making decisions about safer sex practices.  It was designed for showing in sexually transmitted disease (STD) clinic waiting rooms. A controlled multisite trial found significantly lower STD incidence during follow-up for patients who visited the clinics while the video was being shown versus those who visited when it was not shown.

Objectives: To estimate the cost of producing and disseminating SITC.

Methods: We estimated production costs, including ongoing guidance from a multidisciplinary research team to create theory-grounded prevention messages, costs for multiple rounds of focus groups (to tailor prevention messages and storylines for the intended diverse audience of viewers), filming, and production of 1650 kits (posters, users’ guide, and DVD), and similar downloadable materials.  Estimated costs (2002 US dollars) included $3000 per clinic for flat-panel televisions, DVD players, and sound systems, and labor cost for equipment operation by clinic staff.

Results: SITC cost approximately $307,000 to produce and distribute, or $186 per kit when averaged over the 1650 kits that were distributed.  The total cost per clinic to obtain and show the video was approximately $230 per month over the study period.  Assuming 28% depreciation per year and existing hardware would lower the cost per clinic to $139 per month.

Conclusions: Video-based interventions can be produced at a low per-unit cost, assuming the finished product is widely distributed, even given the pre-production costs involved with this multisite study. Monthly costs to clinics are nominal.

Implications for Programs, Policy, and/or Research: Video-based interventions could be made available to programs, assuming funding for production is available. Wider distribution of kits would lower the per-unit cost.  Programs could then acquire the interventions and make use of clinic waiting time to deliver STD prevention messages.