Shields for Families Project Inc.

The following assessment of program strengths and weaknesses has been abstracted from reviews by the Task Force on Program Selection of The Health Project. Where weaknesses are postulated, it must be taken into account that the review Task Force is very critical, that no programs are perfect, that the Award Winning programs have been selected from over 300 candidate programs and represent the very best, that the materials reviewed may have been incomplete, that suggested deficiencies may have resulted from incomplete understanding of the program by the reviewers or that any problems may have been corrected since the time of review.

Evaluation: The "Shields for Families Project, Inc.", Los Angeles, targets women with alcohol, drug and child abuse problems, drug-affected newborns, high risk siblings and affected family members. Martin Luther King Hospital delivered 1,200 drug exposed infants, and reduced the number to 300 by 1994. Interventions with 40 substance abusing women showed post-natal care costs of $400,000 v. $1,954,000 for non-intervention. Applied to 1,000 similar women surveyed, the cost would have been $10 million v $48 million.

This project addresses a very difficult health problem, targets its audience well, is recognized for quality, and has outcome and cost data. There is strong community integration, the program is comprehensive, and it integrates a physiologic approach with psycho-social interventions. The program goals relating to promoting family reunification are innovative and commendable. The program addresses a critical need of the community. The program has resulted in a significant decrease in the number of drug-exposed infants in South Central LA from 1,200 in 1989 to 300 in 1994 for an estimated savings of over one million dollars. It is a clearly set program with clear objectives. The program is culturally competent. There are excellent cost-benefit analyses published and presented.

This is an expensive intervention and long-term results are lacking. The focus is narrow. There are no controls and some missing data. There are many opportunities for good future studies. Methodology design is unclear. There is no discussion of participants versus non-participants. Dropout rate is relatively high with 47 noncompliant out of 85 and a participation rate of only 40 percent.