Pediatric physical and occupational therapists are in the unique position to provide therapeutic and health promotion interventions to children and youth with special health care needs (CYSHCN) including those with chronic conditions (such as overweight and obesity) in a variety of settings. In this commentary, the authors share their experiences in the design, implementation, and evaluation of health promotion programs in community settings. In community-based programs, a community is defined as any group of individuals who are connected in some way such as living in the same neighborhood, participating in the same church or club, or sharing the same social identity. Community-based health promotion programs may be implemented in schools, churches, community-based organizations (YMCA, Boys and Girls Club), the built environment (streets, parks, and greenways), health facilities (therapy departments, health clinics), and media resources (TV, billboards). (Contains 1 figure.)