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 is an opportunity for states in the United States to receive technical assistance from 100 Million Healthier Lives to coordinate and accelerate their equity and population health improvement journeys. States of Solutions is made available through the generous support of the Robert Wood Johnson Foundation.

States serve as natural units of innovation and system change with shared governance, policy and payment systems. States of Solutions offers change makers within states (state agencies, community coalitions, and networks of communities) to come together to accelerate improvement in health, wellbeing and equity and apply an equity lens to their work. This initiative will provide States the opportunity to build unprecedented collaboration with all stakeholders; commence innovative improvement and develop sustainable system across its network. See a list of states in States of Solutions here.

Click here to read a press release on States of Solutions.


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 2018.

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


Pathways to Population Health

(SCALE Health & Care)

In Pathways to Population Health, partners from 100 Million Healthier Lives are working together to help health care organizations make meaningful and measurable progress in improving health, well-being, and equity in their communities.

In service of this goal, we have come together to:

  1. Develop a clear and cohesive articulation about what the journey to population health entails for health care organizations.
  2. Build a pathway of support that helps health care organizations identify where they are and where they want to go next, and puts curated tools and resources from the field in one place.
  3. Engage and accompany health care organizations on the journey to population health.

For more information, visit

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.

St. Mary’s Nutrition Center Addresses Food Insecurity

St. Mary’s Nutrition Center is a bright spot for reaching outside the center walls and using urban gardening and reclaiming abandoned lots to increase food access and healthy behaviors in the city of Lewiston, Maine. Lewiston poverty rates are high; 22% of residents live under the federal poverty line and 48% of the city’s children under five years old is live below the poverty rate, which is double the state average.

Given the extensive poverty and issues of access to resources in Lewiston, providing education and increasing food access is a critical strategy for building resiliency at an individual, family, and community level. This work cannot be done effectively in a silo or with one strategy alone. The Nutrition Center, along with many changemakers in Lewiston, is using multi-pronged approaches, thoughtful collaboration, and authentic community engagement to create positive change.

As of this summer, the Nutrition Center coordinates 9 community gardens across Lewiston-Auburn where families and individuals can grow food for themselves. All combined, gardens across Lewiston-Auburn will provide more than 200 low-income households the opportunity to grow food for themselves. Through partnerships with the schools, the Nutrition Center offers garden and food club programs for children at 5 elementary schools and 1 middle school. The program reaches more than 2,000 students in over 60 classrooms and after-school sites including 4 neighborhood teaching and learning gardens where kids and teens learn and harvest food for their families. Learn how the St. Mary’s Nutrition Center achieved these results and the stories that accompany their data by reading their Bright spot story here.

University of Vermont Medical Center Addresses Housing

The University of Vermont (UMV) Medical Center’s 2016 Community Health Needs Assessment showed that affordable housing was the top need in Burlington, Vermont. Rather than letting the housing sector take on the work, the Medical Center and its partners in the community came together to address housing issues to improve the health of not only UVM Medical Center patients, but the community at large.

UVM Medical Center leadership knew “this was the right thing to do” but how did they put that emotion into action in service of their mission? UVM Medical Center became involved in three housing initiatives: Harbor Place, Beacon Apartments, and Bel-Aire Apartments. All three facilities have on-site support services provided by community organizations. First, a case manager from the community’s Federally Qualified Health Center, The Community Health Centers of Burlington (CHCB), connects residents with various resources such as medical insurance and permanent housing applications. Second, mental health services are provided by clinicians from the Howard Center, the region’s designated mental health agency, on an ad-hoc basis. Third, medical services are provided by several organizations such as the Visiting Nurse Association and CHCB.

The Beacon Apartments transformed a rehabilitated motel in South Burlington, VT provides 19 permanent, affordable housing units to individuals who were chronically homeless and highly vulnerable. Comparing to baseline data before the apartment complex initiative took place, direct cost for UVM Medical Center patients decreased from $15,044, 0-60 days prior to staying at Beacon Apartments to $3,300 after 61 days at Beacon Apartments. To learn more about their innovative improvements to health of their patients and community, read the UVM Medical Center Bright spot story here.

Member Spotlight

Noé Rubén Chávez, Ph.D. is a psychologist who works with the collaborating on youth empowerment. Through the IHI he learned to develop his public narrative, later using this tool at his own institution to raise awareness of mental health for grad students and postdocs. Through the Open School, Dr. Chávez became an ICAN Coaching Fellow. He was able to help coach 17 students to help with development of their health promotion and health improvement projects.

Nick Christian MD, MBA founded the Student Opioid Coalition in Dayton, Ohio. Michael B. Holbrook is the current president. The organization has worked to fight the opioid epidemic through many impactful projects one such being the Medication Disposal Project. This project involved surveying patients’ perceptions about safe practices of opioid medications as well as providing dispensation of pouches to patients receiving opioid-containing medication. Other projects that the Student Opioid Coalition are working on include Generation Rx and DEA360.

Watch September’s Momentum Call to learn more about these members and their initiatives.


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.

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