Guidelines for obesity management in primary care call for linking to community services. The Promoting Health Project (PHP) was a multi-component, practice-based intervention aimed at improving care of obese children, including referrals to community services. Promoting Health Project staff identified and interviewed representatives of 40 nutrition or physical activity services/programs. Quality improvement (QI) teams at three practices worked to improve overweight/obesity identification and care and implement practice-to-community connections that used the information gathered from the programs/ services. A practice community coordinator (PCC) facilitated interactions between practices, community programs and families. Researchers tracked patients referred, PCC to family interactions, and time spent. They surveyed parents of referred patients and interviewed key clinicians. Forty-six patients participated in programs. Substantial efforts were necessary to create smooth referral systems. Family motivation was perceived as a limiting factor in program attendance. Clinicians were satisfied with systems established. Effectively linking practitioners to community programs requires the use of additional resources.