SCALE 1.0: Becoming Communities of Solutions

SCALE 1.0: The first phase of Spreading Community Accelerators through Learning and Evaluation (SCALE 1.0, January 2015 – January 2017) supported 24 communities across 21 states in the U.S. to accelerate their community transformation journey toward a Culture of Health. These 24 communities, who worked on a variety of health, wellbeing, and equity topics, went on to support 43 additional communities in a program called Pathway to Pacesetters.


The first signature initiative of 100 Million Healthier Lives, SCALE 1.0 helped develop a model of community transformation called Community of Solutions–a set of skills and behaviors that can lead to culture change and sustainable improvement in health, wellbeing, and equity.

SCALE was funded through the generous support of the Robert Wood Johnson Foundation and was created as a collaboration between the Institute for Healthcare Improvement, Communities Joined in Action, Community Solutions, and the Network for Regional Healthcare Improvement.



SCALE Stories of Health & Wellbeing


SCALE 2.0 (launched summer 2017) will expand the use of 100 Million Healthier Lives approaches to over 220 communities and up to 500 health care organizations seeking to accelerate their journey to improve population and community health. The initiative brings together two areas critical for sustained community transformation: changes in both community-wide practices and in key anchor institutions (e.g., health care organizations) within those communities.

SCALE 2.0 is also generously funded by the Robert Wood Johnson Foundation.  Read our press release about this initiative issued on July 10, 2017. 


SCALE 2.0 consists of two related focus areas:

  • SCALE Communities, with three components for communities on the journey to population and community wellbeing:
      1. Regions of Solutions
      2. States of Solutions
      3. Community Health Accelerators Initiative (CHAI)
  • SCALE Health & Care for health care organizations on the journey to population and community health.

Below please find additional information on these initiatives.

Regions of Solutions (SCALE Communities)


In Regions of Solutions, 18 communities from SCALE 1.0 will form regional networks with up to 4-6 communities around them to advance the Community of Solutions approach across a geographic region.

Learn more about Regions of Solutions. 


States of Solutions


States of Solutions will bring the SCALE methods and tools to two states to improve health, wellbeing & equity at the community and state level.

By creating agile statewide networks, engaging at least 35 communities and local funders in each state to host equity action labs; developing community-to-community bright spot site visits; and addressing policy, systems and environmental change, States of Solutions will help communities in each state to learn from one another and accelerate their journey toward health, wellbeing, and equity.


Community Health Accelerators Initiative (CHAI)

Open to all Communities!

CHAI is an online support system to improve community health, wellbeing, and equity open to any community, anywhere at any stage of their improvement journey.

This virtual training and coaching program includes free access to training on the core skills needed to improve health, wellbeing, and equity as well as low cost coaching and advanced training related to concepts of leading from within, leading together, leading for outcomes, leading for equity and leading for sustainability. CHAI modules will be available in the fall of 2017.

Are you interested in learning more about CHAI? Click here.


SCALE Health & Care

In SCALE Health & Care, the Institute for Healthcare Improvement will work with the American Hospital Association, Network for Regional Healthcare Improvement, Public Health Institute, Stakeholder Health and other partners from the 100 Million Healthier Lives’ Health Systems Transformation Hub to support health care organizations to make meaningful progress in population and community health.  

Together they will create a framework and health care transformation map for health care organizations to advance toward population health; harvest and organize support resources across organizations in one, user-centered platform; and engage at least 500 health care organizations to make meaningful, measurable progress on the journey towards population and community health.  

The support system developed in SCALE Health & Care will be available to use by any health care system anywhere.

For more information about SCALE Health & Care, click here.

Are you interested in SCALE Health & Care? Click here to take an interest survey.



Community Initiatives

Communities around the globe participate in the movement in a variety of ways. An example of community initiatives within topical and geographic hubs is listed below. To find more information about community initiatives within the movement, visit our interactive map.

The MyVA Communities model enables Veteran advocates, service providers, Veterans, and stakeholders to have a voice in identifying their community goals and work to resolve issues at the local level to improve service delivery for Veterans, Service members, and their families. Click here to learn more.

Featured Bright Spots

Learn about change agents who are creating bright spots around the globe on the journey to 100 Million Healthier Lives.

Healthy Waterville

Learn about Healthy Waterville’s SCALE journey in this new report from the Maine Health Access Foundation: Healthy Waterville: Increasing Connectedness and Healthy Food for All. Over the last two years in SCALE, Healthy Waterville has addressed issues of healthy food access and social connectedness to reduce inequities in their community. They have partnered deeply with people with lived experience in this work.

From Waterville, Maine and serving northern Kennebec County, Healthy Northern Kennebec (the coalition that anchors Healthy Waterville) is a non-profit, community based coalition, which formed in 1988 with the goal of identifying local health problems and working collaboratively with community agencies, government and local citizens towards a resolution of these problems.

Change Day Australia

Based in Australia – Change Day Australia – is a social movement that invites the health and community care workforce across Australia to make a pledge to do one thing to improve the health and wellbeing of individuals; communities and the Australian health and community care system as a whole. In the first year they gathered more than 15,000 pledges from across Australia and in 2016 we are confidently aiming to collect 50,000 pledges. Learn more here.

Members Spotlight

  1. Mike Rocha MD is working to improve the health of residents in the New Bedford area. He now leads a monthly Wellness Walk the first Saturday of every month and founded the New Bedford Wellness Initiative. 
  2.  Mary Freer is the Founder and CEO of Change Day Australia and works closely with Change Day leaders in many countries across the world to bring about global improvements to our health and social care systems.

Join the Online Community

We invite you to join the 100MLives Community platform. On the 100MLives Community platform you exchange stories, find collaborators, learn and share with other individuals and organizations in the 100MLives movement and how they are affecting health, wellbeing, and equity and their community.

This platform is powered by BraveNew in partnership with 100MLives.


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