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Linking clinical services to community-based resources is a promising strategy for assisting patients with chronic disease prevention and management. However, there remains a gap in understanding how to effectively develop and implement community–clinical linkages (CCLs), especially in communities of color. The Healthy Here initiative used Stage Theory of organizational change to implement a centralized wellness referral system, linking primary care clinics to community organizations in majority Hispanic/Latinx and Native American communities. Data were collected using a standardized referral form. Facilitators and challenges were identified through semi-structured discussions with partner organizations. Between 2016 and 2021, 43 clinics and 497 health care providers made 7,465 referrals, the majority of which were from the focus populations. The average proportion of patients referred by clinic champions decreased significantly over time, reflecting diffusion of the intervention within clinics. Facilitators to system success included building on existing networked partnerships, utilizing a centralized referral center, leveraging funding, sharing data, addressing challenges collectively, incorporating multilevel leadership, and co-developing and testing a standardized referral form and process with a single clinic and provider before scaling up. Challenges included funding restrictions, decreasing referrals within clinics over time, changing availability of resources and programs, and the COVID-19 pandemic. This innovative initiative demonstrates that CCLs can be developed and implemented to successfully reach Hispanic/Latinx and Native American communities and provides strategies for overcoming challenges.

Increased scientific understanding explains why transgender and gender nonconforming (TGNC) youth report more mental health concerns than their cisgender peers. However, the emotional processes of TGNC youth have not been assessed beyond mental health diagnoses. Our aim in this study was to investigate how TGNC youth understand, experience, and label their emotional experiences. We conduced a two-tiered qualitative analysis of 20 predominantly White TGNC youths, ages 7–18 years, resulting in the creation of the appraisal, valence, arousal theory of emotions. Within the theory, emotions are categorized in four quadrants: Reflective/Unpleasant, Anticipatory/Unpleasant, Reflective/Pleasant, and Anticipatory/Pleasant. Results indicated that the majority of TGNC youths’ emotions were located in the Reflective/Unpleasant and Reflective/Pleasant quadrants. The current study highlights TGNC youths’ appraisal of emotions and the potential impact on youths’ cognitive and emotional processes. Interventions should attend to pleasant and unpleasant aspects of emotions while also focusing on youths’ understanding of the context of their emotions.