The "Story Behind the Measure" helps us understand the causes and forces at work that explain the data behind repeat referrals to the Teen Intervene program.

What's Helping Customer Change? These are the positive forces at work in our strategy/program that influence customer change.

• Accessibility/Location;  provided during the school day
• Alternative to Out of School Suspension
• Strong partnership with the school 
• Dedicated, trained staff to implement the program 
• Madison Middle School referrals are considered discipline and can affect participation in athletics

What's Hurting Customer Change? These are the negative forces at work in our strategy/program that influence customer change.

• Inconsistency in discipline and implementation across Madison Middle School, Madison High School, Madison Early College High School
• Lack of participation in Teen Intervene from parents
• Rules at home regarding substance use sometimes differ from school rules

The following actions have been identified by the Madison Substance Awareness Coalition (MSAC) as ideas for what can work for this performance measure to make a difference on youth tobacco/substance use.

Actions and Approaches Identified by the Madison Substance Awareness Coalition: These are actions and approaches that we think can make a difference for this performance measure.

• Mandatory parent involvement after the first referral
• Grade level meetings to review school substance policy and consequences
• Enforcement of discipline policy

No-cost and Low-cost Ideas Identified by Madison Substance Awareness Coalition: These are no-cost and low-cost actions and approaches that we think can make a difference for this performance measure.

• Review and discuss at School Health Advisory Council (SHAC) meetings
• Tie to Performance Based Incentive System (PBIS) rewards
• Poster campaign to remind people of our policy

What your communities served/customers think would work to do better These are actions and approaches that our communities served/customers think can make a difference for this performance measure.

• For county government to implement a nicotine/tobacco free policy
• Increased staff and other adult enforcement at afterschool or school-sponsored events
• Recognize and further address the root cause of use and addiction