Developed by Seabourne Consulting, experts in Leadership Skills that Create Communities of Solutions

Leadership Skills that Create Communities of Solutions

This story was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.

Our Theory of Change


Leaders using these five Community of Solution skills will build a culture of health and equity.

When we learn and use the "Community of Solutions" leadership skills, we develop behaviors, processes and systems that result in improved population health, well-being and equity.

With the support of The Robert Wood Johnson Foundation (RWJF), the Healthy Northern Kennebec (HNK) coalition in Waterville, Maine, participated in the 100 Million Healthier Lives "Spreading Community Accelerators through Learning and Evaluation" (SCALE) initiative from 2015 – 2019. The SCALE initiative helped our community achieve unprecedented success in addressing social determinants of health, promoting health equity, and accelerating our journey toward a Culture of Health, using this "Community of Solutions" framework.

We believe that confident, connected, collaborative, and caring community leaders will create a culture of health for all. The Healthy Northern Kennebec coalition shares leadership tools at each monthly meeting, at our annual planning meeting, and even at community celebrations!

In 2018, HNK joined with partner organizations serving the Kennebec Valley to scale up these leadership concepts and skills to even broader audiences, including the health, education, social service, business, economic development, labor, arts, and faith communities. Together with Waterville community members who have lived experience, we co-designed a series of three day-long leadership workshops that were free and open to the public. About 150 emerging leaders from our Central Maine region learned and practiced the leadership skills described below.


Healthy Northern Kennebec coalition members work in cross-sector partnerships.


Leading from Within

Leading from Within is your own inner journey as a leader, including the ability to:

  • Know yourself
  • Reflect and change as needed
  • Believe in abundance, even in the midst of scarcity
  • Value difference - "Habits of the Heart"


Scott McAdoo - Resident of Waterville's South End Neighborhood and Community Champion

- Interviewed by Matt Guy, SCALE Coach


Scott McAdoo at Waterville's SCALE-Up Leadership Training, October 30, 2018.

What has changed for Scott as a result of learning Community of Solutions (CoS) skills?

Scott's big journey along the way of SCALE has been from being a quiet, "back of the room" type, to leading a group and presenting stories. It's given him the change to grow as a leader.  Scott says sometimes there is still the stigma of "not being known" (lots of assumptions being made about him), and really wading into the unknown.

His eyes have been opened more in a variety of ways; his horizon has been widened.  Waterville is a diverse place, but he now sees a fuller view of the diversity of Waterville. Levels of economic success (or lack thereof) are not only rich or poor, but a wide range. Scott also has appreciated being able to see how the community has developed via its history, learning how cultures didn't mingle when they came to Waterville and how that lack of interplay has led to some of the problems that exist today.

How would Scott describe his experience with the Healthy Waterville Action Team?

Scott has really appreciated being a part of the Healthy Waterville Action Team and getting to know Action Team members. He enjoyed being part of the creation and execution of the SCALE Up events (three Community Leadership Trainings in 2018). Scott was most impacted by the Bright Spot visits to learn from and share with other Maine communities working on food equity.

His being seen more in the community has created greater connections for himself, and the Healthy Waterville Action Team. Scott's involvement has allowed him the chance to be vulnerable and grow through learning. (Change as a positive!)


Tina Chapman - Organizational Leader and Community Connector

- In her own words

How do you describe your personal growth and change as a result of learning Community of Solutions (CoS) skills and behaviors?

For me personally, bringing the issue of race, racism and equity into the forefront was especially enlightening.  Those of us who live in a very predominately white culture are not challenged in our thinking and ways of being related to racial inequities or disparities because its not right in front of us.  I was particularly impressed with the presentation at the last CHILA (Community Health Improvement Leadership Academy) from REI (Racial Equity Institute) which really underscored for me how systemic racism is – and how we as a society are perpetuating negative outcomes for people of color.

Also, learning more about how important it is to lead for equity.  Before this project, I wouldn’t have voluntarily gone into a food bank or a soup kitchen to receive services.  I wouldn’t have thought to have 'to go' containers available at a community meal so that people who are food insecure could take the extra food home, to make sure there was free transportation available, or to have name tags without job titles which sets up an “us” vs. “them” dynamic.

More generally, I particularly liked the Five Habits of the Heart and the Circle of Trust Touchstones – both of which set the stage for being open to truth, open to discussion, open to learning, and open to change.

How do you describe Waterville's growth and change as a result of learning CoS skills and behaviors?

The CoS skills have provided our community with a great foundation to move all of our endeavors forward in a very thoughtful manner. We have had much success already!  Together, we have redefined our coalition’s vision and mission which really encompasses that “we are all in this together.”

With Healthy Waterville, we could not have achieved the outcomes that we have without leading for equity. Having people with lived experience being an integral part of the process - seeing all of our coalition members grow, take on leadership roles and be part of the dynamics of community change has been wonderful.

And, going back to the very beginning when we did our initial focus groups, hearing that “feeling like no one cares is worse than being hungry” I think resonated with many of us and is why we have all been so committed to this opportunity to create positive changes within our community.


Tina Chapman, former HNK Board President, former President of Waterville Rotary Club, former CEO of United Way of Mid-Maine, current Director of Development and Communications at Kennebec Behavioral Health and Healthy Waterville Steering Committee member (April 2019)

Leading Together

The community is a dynamic network of people, organizations, and systems. We need to lead together with others to create effective, equitable change. Leading Together skills include:

  • Developing trust and relationships
  • Effective teamwork
  • Collaboration (including people with lived experience)


Waterville residents listen riveted as Dr. Soma Stout shares stories of local leadership from around the world.

Positive change is possible when we all listen, learn, and lead together!

In June 2016, HNK planned a community event to bring together professionals, organization leaders, and Waterville residents living in poverty to celebrate the HNK coalition and development of the Healthy Waterville Action Team. The intent of the event was to create a space where about 100 diverse participants would bridge socioeconomic differences, talk, listen to music, eat dinner, recognize each other’s humanity, have fun, and plan to lead toward community solutions together. Dr. Soma Stout gave an electrifying presentation that inspired all that! 

At this event, leaders with power listened more than they spoke. Unexpected voices spoke clearly. All participants left with a greater sense of hope and possibility.

Change is possible when we work together! See the faces and hear the wisdom of our Waterville community members in this fabulous presentation by Dr. Soma Stout. (48 minutes)

Leading for Outcomes

Together, we created a theory of change, identified measures, tested the theory, and planned improvements that will grow and last. We used:

  • Design Thinking – Using stories to understand the experience of people affected by change
  • Improvement science – Developing aims, drivers, and measures, and testing our ideas to learn what works
  • Implementation skills – Making what we do easier, more effective, and more joyful


Community Transformation is possible. Change is happening in the Greater Waterville region!



The Community Transformation Map (CTM) is a 40-question planning and assessment tool. It is designed to help communities make meaningful, measurable improvements in health, well-being and equity, to advance toward a Culture of Health.

Section 1 (Blue) - How the community approaches the change process

Section 2  (Red) - How members of the community relate to one another and create abundance

Section 3 (Yellow) - How the community leads for social change and equity

From September 2017 through March 2019, Healthy Northern Kennebec (HNK) coalition members answered the 40 "Community Transformation" questions four times. Scores were averaged. Our group had fascinating discussions about our different opinions at HNK coalition meetings in the fall of 2018 and spring of 2019. 

HNK coalition members agreed that the Greater Waterville region has made progress in: Vision, Co-design, Applying improvement methods, Willingness to adopt change created by others, Sustainability and scale-up, Organization of the community collaboration, Communication and conflict resolution, Shared stewardship, Growing the leadership of those most affected by inequity, Distributed power and leadership, and Taking effective action to improve equity. 

As the graph shows, Community Transformation scores progressed every six months. Scores increased even more after the series of three regional Leadership Trainings, held in Waterville in the fall of 2018.

Leading for Equity

Equity considers justice and fairness for everyone. Leading for Equity is included in all the Community of Solutions skills:

  • Leading from Within – Understanding implicit bias, power and privilege
  • Leading Together – Building relationships across differences, Mapping assets by sharing stories
  • Leading for Outcomes – Using data to understand who is not thriving, Testing improvements that could change unhealthy systems
  • Leading for Sustainability – Using a mindset of abundance, Working strategically to make lasting changes 


Community Health Improvement Leadership A