In 2003, the Swedish Parliament adopted a national public health policy that included the domain - “A more health-promoting health service”. Strategies and tools are needed in the work to reorient health services. Personal health documents are documents concerning a person’s health, and are owned by the individual. Several studies that have evaluated such documents indicate that they could be of interest in health-promotion work. However, there is insufficient knowledge concerning personal health documents that target adolescents, and little is known about the feasibility of such documents in a Swedish cultural context. The concept of empowerment is gaining increased interest for health services, but the associations between empowerment, self-rated health and health behaviour are sparsely studied. The overall aim of the thesis is to explore a strategy - empowerment - and a tool - personal health documents - that might facilitate the work of the public health goal of a health-promoting health service. Specific aims are to examine the feasibility of using personal health documents in health promotion; to examine professionals’ experiences of working with health promotion and personal health documents; to examine the association between personal health documents and self-reported health behaviour change; and to examine the perception of empowerment in relation to self-rated health and health behaviour among adolescents. Two personal health documents that targeted adults and adolescents were developed and evaluated. Distribution to adults in different settings was compared in a cross-sectional study (n = 1 306). Adolescents received the document in school, and surveys were performed at baseline and after one year (n = 339). Practical use and attitudes by document owners were studied by questionnaires. Teachers (n = 69) answered a questionnaire, and community health nurses were interviewed (n = 12). The interviews also explored nurses’ experiences of working with health promotion in general, and were analysed by qualitative methodology. Adolescents’ empowerment was examined by a questionnaire (n = 1 046). Most participants reported reading in the documents; writing in the documents varied between 16% (distribution in occupational health) and 87% (adolescents). The health document was perceived as useful by 35% of the adolescents. Factors significantly related to personal usefulness were being born outside Sweden, experiencing fair treatment by teachers, being a non-smoker and having a positive school experience. Community health nurses were striving for a balance of being a doer of practical, disease-oriented tasks and a health-promotion communicator. The structural organisation in health care centres was important for their work with health promotion and the health document. Teachers were generally in favour of continued work with the document. In different settings, between 10% and 26% of adults reported changes in their health situations as a result of reading the booklet. Self-reported changes in health situations were less likely using postal distribution, and there were no significant differences between the other types of distribution. Adolescents with low empowerment scores reported poorer self-rated health and more risk-taking behaviours such as smoking and binge drinking. To conclude, personal health documents are feasible to use in different settings. Health promotion in health services needs active support from leaders as well as adequate support systems. Findings suggest that personal health documents can be tools for promoting self-reported lifestyle changes among adults in different settings. There is a close relation among adolescents between low empowerment in the domain of health, low self-rated health and health behaviours such as binge drinking and smoking.

Medical treatments with statins are prescribed to patients with increased risk of cardiovascular events. The benefits from statin treatment are well documented in clinical trials, but long-term adherence in patients is low, indicating that patients have an uncertainty about the necessity and benefits of treatment. The aims of this thesis were to investigate how patients and doctors view different aspects of statin treatment. Further aims were to investigate if the cardiovascular risk level in patients affects their views about different aspects of statin treatment. Yet further aims were to compare health behaviours and views about risk factors in patients using statins to a non-treated population. Data was obtained from patients (n = 829), doctors (n = 330) and a population sample (n = 720) using postal questionnaires. Views about the effect of statin treatment were assessed in different ways for patients and doctors. Patients based their assessments on their own situation, and doctors’ treatment decisions and assessments of anticipated effect of treatment were based on two hypothetical patient cases. The results indicate that patients greatly overestimate the general effect of statins, compared to efficacy results reported from clinical trials. Patients’ previous coronary heart disease or high overall risk were factors not associated with their views and expectations of treatment effect. Statin users with an internally perceived health control and patients satisfied with their doctor’s treatment explanation reported higher beliefs in treatment necessity and benefits. Statin users reported having better health behaviours and generally rated risk factors as more important than the non-treated population. Doctors had suboptimal understanding of the number of patients expected to benefit following five years of statin treatment and had a varying understanding of statins’ ability to prolong life. Overall the results illustrate that patients and doctors have different perspectives and views of the benefits from statin treatment which puts emphasis on how statin treatment is discussed in the clinical setting.

This thesis is concerned with an evaluation of AIDS education in KwaZulu-Natal schools. Although HIV and AIDS affect all segments of the population and all age groups, prevention efforts aimed at the youth may be the most effective. HIV/AIDS is a disease most prevalent in the fifteen to thirty-five age group, and if we can decrease rates of transmission in people under twenty, we will save much money, pain and suffering in the next ten years. It is often seen as prudent to save young generations, rather than older ones, and this may be especially true in the case of HIV/AIDS, where HIV/AIDS in the younger, reproductive age groups leads to the very youngest group, that it, babies, being born HIV-positive. In addition, the younger generation may be more easy to save: they have not yet formed unsafe sexual practices, and educating them before they develop habits is easier than changing habits of the older generation. I assessed various education departments' AIDS education programmes, based on the criteria of how well pupils are assisted in changing their unsafe sexual practices, or, if they are not yet sexually active, their attitudes towards sex, and on what type of message and ideal is presented about sexuality and sexual activity. Judged by my framework, I found the existent programmes to be lacking. But this act of assessment allowed for a more thorough evaluation of AIDS education in the region to emerge, and from this, recommendations for AIDS prevention programmes to be developed: AIDS education must occur in the context of more general skills development, skills in negotiating sexuality and sexual relationships, and skills for the negotiation of life in the late twentieth century. Innovative developments in the region, regarding AIDS and sexuality education teacher training, and the development of minimum criteria by which to set up and judge programmes, could be used as the basis for a sound AIDS education programme. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 1996.

Šiame darbe atlikto tyrimo tikslas - išanalizuoti vaikų globos namuose gyvenančių paauglių psichologinio atsparumo ir sveikatai palankaus elgesio sąsajas. Tyrime dalyvavo 173 paaugliai, gyvenantys aštuoniuose vaikų globos namuose visoje Lietuvoje. Tyrime dalyvavo paaugliai nuo 11 iki 18 metų, 90 (52 %) berniukų ir 83 (48 %) mergaitės. Šiam tyrimui atlikti buvo sudarytas 99 klausimų klausimynas. Klausimynas susidėjo iš dviejų dalių. Pirmoji dalis buvo sudaryta remiantis The California Healthy Kids Survey klausimyno 2010 – 2011 metų moduliu B ir skirta ištirti paauglių psichologinio atsparumo ypatumus. Antroji dalis sudaryta remiantis Health Behavior Questionaire (Jessor, Donovan, Costa, 1992) pagrindu. Ja buvo siekiama išsiaiškinti paauglių sveikatai palankaus elgesio ypatumus. Tyrimo rezultatai parodė, kad didėjant vaikų globos namuose gyvenančių paauglių psichologiniam atsparumui, daugėja sveikatai palankaus elgesio. Labiausiai vaikų globos namuose gyvenančių paauglių sveikatai palankus elgesys yra susijęs su namų, draugų, asmenybės apsauginiais veiksniais, o mažiausiai – su mokyklos bei visuomenės apsauginiais veiksniais. Taip pat didėjantis vaikų globos namuose gyvenančių paauglių psichologinis atsparumas susijęs su mažėjančiu paauglių rūkymu, alkoholio bei narkotinių medžiagų vartojimu, su geresniu paauglio mitybos dienos režimu bei tuo, ar paaugliui rūpi, kad jo maistas būtų sveikas. Be to, didėjant vaikų globos namuose gyvenančių paauglių psichologiniam atsparumui... [toliau žr. visą tekstą] / The aim of the study was to explore links between psychological resilience and positive health behaviour of adolescence in foster care. The subjects of the study were 173 adolescences, living in eight foster care homes in all Lithuania. Adolescences were from 11 till 18 years old, 90 (52 %) boys and 83 (48 %) girls. Questionnaire of 99 questions was made special for this study. Questionnaire consisted of two parts. First part of questionnaire was made by example of The California Healthy Kids Survey 2010 – 2011, module B. It was intended to explore psychological resilience’s features of adolescences in foster care. Second part of questionnaire was made by example of Health Behaviour Questionnaire (Jessor, Donovan, Costa, 1992) and it was intended to explore positive health behaviour’s features of adolescences in foster care. The results of the study showed that increasing of psychological resilience of adolescences in foster care is related with increasing of positive health behaviour. Positive health behaviour of adolescences in foster care, was related with protective factors of home, friends, personality most of all. Positive health behaviour of adolescences in foster care was related with protective factors of school and society least of all. Increasing of psychological resilience of adolescences in foster care is related with decreasing consumption of drugs, cigarettes, alcohol. Also increasing of psychological resilience of adolescences in foster care is related with... [to full text]

Type 2 diabetes is a global health problem. Evidence indicates that type 2 diabetes can lead to serious complications, such as a cardiac event, which usually require critical nursing care. Patients with type 2 diabetes and with a history of cardiac disease are at greater risk of a further cardiac event requiring readmission to hospital. Evidence indicates that improved diabetes management assists patients with type 2 diabetes to manage their condition efficiently, reduces risks of a further cardiac event, and therefore reduces hospitalisations. However, there is limited information found regarding a diabetes management program specifically for patients who have already had cardiac complications. Difficulties in developing patients' skills in managing and modifying their daily lives also present a challenge to coronary care staff. Therefore, there is a real need to develop a special diabetes management program for patients with diabetes who have experienced a critical cardiac event, which will be commenced in the Coronary Care Unit (CCU). The aim of this research is to gain a greater understanding of the characteristics, secondly to obtain in-depth understanding of needs and experiences of patients with type 2 diabetes hospitalised for a critical cardiac event. A further aim is to develop and pilot test a diabetes management program, specific to the patients with diabetes in the context of the CCU. The design of this research employed three studies: Study I was an exploratory study, which obtained patients' demographic and disease characteristics from the hospital records of all patients with diabetes admitted to the CCU of one public hospital between 1 January 2000 to 31 December 2003. Study II used a qualitative interpretative approach and aimed to gain an in-depth understanding of the perspectives of patients with type 2 diabetes who have experienced a critical cardiac event in managing their everyday lives with both diabetes and cardiac conditions. Study III included two parts. The first utilised the information from the first two studies and the literature (self-efficacy theory) to develop a diabetes self-management program specifically for patients with diabetes who have had a critical cardiac event. The second part pilot tested the newly-developed diabetes self-management program for patients with diabetes admitted to CCU following a critical cardiac event. The pilot study used a randomised controlled trial research design to evaluate the efficacy of the program. Study I collected data from one hospital's records retrospectively from 2000 to 2003. The results of Study I showed there were 233 (14.7%) patients admitted to CCU that had diabetes out of the total 1589 CCU admissions during the study period. More than 22% of CCU patients with diabetes were readmitted to hospital within 28 days, compared to 6% of CCU patients without diabetes. Patients with diabetes who had a longer CCU stay were more likely to be readmitted. These results indicate that a significant proportion of a CCU population had type 2 diabetes and is more likely to be readmitted to hospital. Study II used an interpretive approach comprising open-ended interviews to collect data from patients with type 2 diabetes experiencing a cardiac event who had a CCU admission in 2000-2003. The findings revealed that patients with diabetes who had a critical cardiac event experienced considerable feelings of hopelessness and fatigue. Patients also had concerns in the areas of self-confidence and confidence in health professionals. Patients indicated that greater self-confidence and confidence in health professionals would help their ability to manage their daily lives. Therefore, it is very important that intervention programs for these at-risk patients need to improve patients' confidence levels, and reduce their feelings of hopelessness and fatigue. The information gathered from Study I and Study II provided important insight into the development of an effective diabetes self-management specifically designed for patients with type 2 diabetes following a critical cardiac event, which is presented in Study III in this thesis. Study III also provided a preliminary evaluation of the newly developed program. The evaluation used a randomised controlled trial research design for the new program and the current educational program provided in the CCU. The results of the program indicate the feasibility of commencing the new diabetes self-management program in the CCU, and to be continued in wards or at home. The results also showed significant improvements in patients' knowledge in the experimental group, but not in other outcome variables (self-efficacy, vitality and mental health levels). However, as a small sample size was used in this pilot study, a larger study is needed to ensure adequate testing of the intervention. Future research is also recommended to incorporate the new diabetes self-management program into the current cardiac education program. Staff's further professional development in providing such a program also needs to be examined. Improvements in quality of care, and patients' quality of life are expected in the future.

The purpose of this study was to understand the factors that encourage midlife women to make exercise and dietary changes, the prevalence of those changes, the process by which women make them, the factors that support or impede them, and how we can enhance women’s capacity to make health behaviour changes in midlife. Since the literature highlighted the importance of self-efficacy in changing health behaviour, and of health-related quality of life as a widely recognized measure of women’s mental and physical wellbeing, the study sought to understand the relationship between exercise and dietary self-efficacy, health behaviour change and health-related quality of life (SF-36), by testing a modified version of Bandura’s 1977 and 2002/2004b models of self-efficacy. The methodology involved postal surveys as well as semi-structured interviews with a subsample of the women who completed the survey. Surveys were sent to 866 women aged 51-66 years from rural and urban locations in Queensland, Australia. Five hundred and sixty-four (69%) were completed and returned. Survey data was analysed using descriptive and bivariate statistics and structural equation modeling. Thematic analysis was used to analyse interviews. The results confirmed that midlife is a significant time for women to make positive health behaviour changes. Almost 40% of women made a change to their exercise and around 60% made a dietary change since turning 40. The main exercise change was doing more walking and the most common dietary change was reducing fat intake. Self-efficacy was shown to be a key influence on whether women made positive changes to their health in midlife. In the relationship between health behaviour change and health-related quality of life, making a positive change to exercise was significantly related to physical but not mental health, and making a dietary change was not related to either physical or mental health. Body mass index was shown to be an important influence on both self-efficacy and health-related quality of life (particularly physical health). Interviews were conducted with 29 of the participants. Interview data reinforced that the main motivations to make a positive health behaviour change among midlife women were being overweight, having an injury or being diagnosed with an illness or health condition. Witnessing the hardship experienced by others with a degenerative disease could also prompt a positive behaviour change. Successful changes mainly involved modifying existing practices and repeating new behaviours until they became part of the daily routine. The main facilitators of health behaviour change were having positive role models, having more time due to retirement, and having support from significant others (such as husbands), health professionals and organizations such as Weight Watchers. The main obstacles to making changes were work, care giving, illness and injury. Bandura’s (1977, 2000/2004b) model was partially supported, but the cross-sectional nature of the study may have been a limitation in demonstrating all aspects of the self-efficacy process. In summary, women are willing to make positive health behaviour changes in midlife, but they need education and support to have those changes be effective. It is anticipated that this research will lead to a greater understanding of the significance of midlife as a time for making healthy lifestyle changes that have the potential to improve women’s health and quality of life in later years.

Abstract This study increases the understanding of young men’s everyday health information literacy and behaviour in relation to their health behaviour, physical health, and socio-demographic characteristics. The conceptual framework of the study builds upon theories of information behaviour, practices and literacy, and health behaviour change. The empirical data were collected with questionnaires (n = 3,293) and physiological measurements (n = 3,063) in 2010 to 2013 at the Finnish Defence Forces’ call-ups, where a population-based sample of young Finnish men could be reached. Everyday health information literacy was studied using a previously developed screening tool, and with a focus on its relationship with health behaviour and physical fitness. Information behaviour was investigated in the context of physical activity, and in relation to men’s readiness to change exercise behaviour according to the Transtheoretical Model. Statistical analyses of the data include multivariate regression analyses, and a critical realist approach was adopted in interpreting the results. The results show that general upper secondary education and higher socio-economic position of a parent increase the likelihood of good health information literacy. Health information literacy is positively associated with health-promoting behaviour and health independent of socio-economic position; confidence in one’s abilities to find, evaluate and use health information is associated with regular exercise and healthy eating habits, and good physical fitness, for example. In the context of physical activity, the practices used to acquire information are associated with the stage of exercise behaviour change. Men in the maintenance stage seek information most actively. Information avoidance, in turn, is connected to low health information literacy, not to the stage of change. The study provides novel knowledge on healthy young people’s everyday health information literacy and behaviour, and on their relationship. It is among the first to investigate health information behaviour in the stages of behaviour change and health information literacy in connection with objectively measured fitness. It proposes a framework for future studies on the relationship between health information literacy and behaviour, and health information outcomes. The results may be utilised when designing tailored health communications and health information literacy education. / Tiivistelmä Tutkimus lisää ymmärrystä siitä, millainen yhteys nuorten miesten arkielämän terveystiedon lukutaidolla ja terveystietokäyttäytymisellä on terveyskäyttäytymiseen, fyysiseen terveyteen ja sosiodemografisiin tekijöihin. Sen käsitteellinen viitekehys rakentuu tietokäyttäytymisen ja -käytäntöjen, terveystiedon lukutaidon sekä terveyskäyttäytymisen muutoksen teorioille. Tutkimuksen aineisto kerättiin kyselyillä (n = 3 293) ja fysiologisilla mittauksilla (n = 3 063) vuosina 2010–2013 Puolustusvoimien Oulun alueen kutsuntatilaisuuksissa, joissa oli mahdollista saavuttaa suomalaisten nuorten miesten väestöpohjainen otos. Terveystiedon lukutaitoa arvioitiin aiemmin kehitetyllä seulontavälineellä sekä suhteessa terveyskäyttäytymiseen ja fyysiseen kuntoon. Terveystietokäyttäytymistä tarkasteltiin liikunnan kontekstissa ja suhteessa transteoreettisen mallin mukaiseen liikuntakäyttäytymisen muutosvalmiuteen. Aineistot analysoitiin tilastollisesti monimuuttujamenetelmin, ja tuloksia tulkittiin kriittisen realismin näkökulmasta. Tulokset osoittavat, että lukiokoulutus ja korkeassa sosioekonomisessa asemassa oleva vanhempi lisäävät hyvän arkielämän terveystiedon lukutaidon todennäköisyyttä. Terveystiedon lukutaito on positiivisesti yhteydessä terveyttä edistäviin elintapoihin ja terveyteen sosioekonomisesta asemasta riippumatta. Luottamus omiin kykyihin löytää, arvioida ja ymmärtää terveystietoa on yhteydessä muun muassa säännölliseen liikuntaan ja terveellisiin syömistottumuksiin sekä hyvään fyysiseen kuntoon. Liikunnan kontekstissa terveystietokäytännöt kytkeytyvät käyttäytymisen muutosvaiheeseen. Aktiivisimmin liikuntatietoa hankkivat liikuntakäyttäytymisen ylläpitovaiheessa olevat. Tiedon välttäminen sen sijaan on yhteydessä alhaiseen terveystiedon lukutaitoon, ei muutosvaiheeseen. Tutkimus tuottaa uutta tietoa nuorten, terveiden ihmisten arkielämän terveystiedon lukutaidosta ja terveystietokäyttäytymisestä sekä niiden suhteesta toisiinsa. Uutta on myös terveystietokäytäntöjen tutkiminen terveyskäyttäytymisen muutosvaiheissa ja terveystiedon lukutaidon tarkastelu suhteessa objektiivisesti mitattuun fyysiseen kuntoon. Tutkimuksessa esitetään viitekehys tuleville tutkimuksille terveystiedon lukutaidon ja tietokäytäntöjen vaikutuksesta terveyteen. Tulokset ovat hyödynnettävissä räätälöidyn terveysviestinnän ja terveystiedon lukutaidon koulutuksen suunnittelussa.

Chronic diseases are usually the result of complex interactions between various lifestyle factors, physiological processes and societal factors. While some of these factors are not modifiable, modification of several of these factors have, to a large extent, demonstrated preventative properties against the development or further development of various chronic diseases. Health-related behaviours are modifiable factors. Behaviour plays an important role in both the development and the management of chronic diseases. One way of investigating this role is to evaluate the impact of health-related behaviours on health. Positive health-related behaviours include eating a healthy diet, regularly engaging in physical exercise, having regular screenings and checkups, not smoking, moderate alcohol use, getting vaccinations and seat belt use. Negative health-related behaviours include eating an unhealthy diet, leading a sedentary life style, not having regular screenings and checkups, smoking, excessive alcohol use and irresponsible driving. Various models of health-related behaviour use social cognitive factors as proximal determinants of health-related behaviours. A social cognitive factor that has received little attention in relation to health-related behaviour, that is sense of coherence (SOC), was used in this study. Although personality factors tend to be only distally associated with health-related behaviour, they do however seem to contribute to a better understanding of these behaviours. Trait emotional intelligence (EI) as a lower order personality trait was used in this study. The purpose of this study was to investigate the nature of the relationships between SOC, trait EI and health-related behaviours. A cross-sectional, correlational research design was used. Participants were selected based on convenient and easy access. Participants completed an online questionnaire that consisted of a health behaviour survey as well as the short form of the Orientation to Life Questionnaire and the Trait Emotional Intelligence Questionnaire. The health behaviour survey assessed some aspects of people's health-related behaviour, including diet, sleep and preventive behaviours, alcohol use, exercise and smoking. Health behaviour correlated significantly with both SOC and Trait EI. SOC and Trait EI were also significantly correlated. When controlling for a third variable, neither SOC nor trait EI correlated significantly with health behaviour. Although none of the predictors made significant contributions to the prediction of health behaviour, the basic regression model reached statistical significance. Trait EI made a significant contribution to the prediction of health behaviour in a more parsimonious regression model, which also reached statistical significance. / Dissertation (MA (Research Psychology))--University of Pretoria, 2008. / Psychology / unrestricted

The psychological sciences offer a large spectrum of theories, principles, and methodological approaches to understand mental health, normal and abnormal functions and behaviours, as well as mental disorders. Based on continued research progress, psychology has derived a wide range of effective interventions for behaviour change and the prevention, treatment and rehabilitation of mental disorders. Thus, psychology and clinical psychology in particular should be regarded as the ‘mother’ science for psychotherapy and psychotherapeutic practice. This paper provides a selective overview of the scope, strengths and gaps in psychological research to depict the advances needed to inform future research agendas on mental disorders and psychological interventions in the context of psychotherapy. Most maladaptive health behaviours and mental disorders can be conceptualised as the result of developmental dysfunctions of psychological functions and processes, and as associated neurobiological and genetic processes in interaction with behaviour and the environment. An integrative translational model, linking basic and experimental research with clinical research and population-based prospective longitudinal studies is proposed for improving identification of critical core vulnerability and risk factors and core pathogenic mechanisms. The proposed framework is expected to allow a more stringent delineation of targeted preventive and therapeutic psychological interventions and an optimisation and better understanding of cognitive-behavioural therapies and other psychological interventions. Based on a European consultation process, a ‘Science of Behaviour Change’ programme with the promise of improved diagnosis, treatment and prevention of both healthrisk behaviour constellations and mental disorders is proposed. / Psychologie als «Mutterwissenschaft» für Psychotherapie und psychische Gesundheit Psychologie als Wissenschaft bietet ein breites Spektrum an Theorien, Grundlagen und methodischen Ansätzen, um psychische Gesundheit, normale und gestörte Funktionen und Verhaltensweisen sowie psychische Störungen zu erforschen und zu «verstehen». Auf dieser Grundlage haben sich in der Klinischen Psychologie vielfältige effektive, psychologisch begründete Interventionen für die Prävention, Behandlung und Rehabilitation von psychischen Störungen ausdifferenziert. Damit ist die Psychologie als «Mutterwissenschaft » der Psychotherapie und psychotherapeutische Praxis anzusehen. Der Beitrag versucht auf der Grundlage einer Stärken-/Schwächen-Analyse der psychologischen Forschung diejenigen Themenbereiche zu definieren, die für Erkenntnisfortschritte bei psychischen Störungen und die psychotherapeutische Interventionsforschung besonders vielversprechend sein könnten. Dysfunktionale bzw. abweichende Verhaltensweisen wie auch psychische Störungen lassen sich als entwicklungsbezogene Störungen psychologischer Funktionen und Prozesse und damit assoziierter neurobiologischer und genetischer Prozesse konzeptualisieren. Für eine verbesserte Identifikation von zentralen Vulnerabilitäts- und Risikofaktoren sowie ätiologisch relevanten Schlüsselprozessen wird ein integratives translationales Modell vorgeschlagen, welches die Grundlagen- und experimentelle Forschung mit klinischer Forschung, Translation und Public-health-Implikationen verknüpft. Damit soll auf der einen Seite eine stringentere Ableitung gezielter Interventionen erleichtert werden, andererseits aber auch eine bessere Identifikation der zentralen Wirkfaktoren und Wirkprozesse psychologischer Therapien ermöglicht werden. Basierend auf einem europäischen Experten-Beratungsprozess wird ein EU-Programm ‘The science of behavior change’ angeregt.

Magister Public Health - MPH / Background: Dental canes and gingivitis are reported to affect 60-90% of school children in most countries (World Health Organization, 2003). Learners in the Swakopmund district of Namibia were examined and it was found that 73% and 89% of them were affected by dental caries and gingivitis respectively (Ministry of Health and Social Services, 2003). This district has implemented an oral health programme at primary schools with the aim of reducing the prevalence of dental caries and gingivitis. Aim: To compare knowledge, attitudes and behaviour of teachers and learners in response to the school-based oral health programme at four primary schools in Swakopmund district. Study Design: This study is a cross-sectional survey that compared the responses of learners from high participating schools to those from low participating schools. The total sample was 186 participants comprising of 159 learners and 27 teachers. Data Collection: Structured, self-administered questionnaires were used for the teachers whilst learners were interviewed by the researcher and research assistants using structured questionnaires. Data on knowledge of risk factors for dental caries and gingivitis as well as attitude and behaviour towards prevention of these diseases at school were collected. Data analysis: Data were captured in Microsoft Excel Programme and imported to CDC Epi Info 2002 version 3.3 for analysis. Prevalence ratio (PR) was used as a preferable measure of effect at 95% confidence interval. Chi-square test was used to assess statistical significance of the proportional differences between high and low participating schools and the cut off point for statistical significance was a p-value < 0.05. 111 Results: Learners from low participating schools were more knowledgeable than learners from high participating schools in most of the knowledge questions and the results were statistically significant. There were positive oral health practices and attitudes reported by the learners with minimal differences between high participating and low participating schools and consequently the results were not statistically significant. The results for the variables knowledge, behaviour and attitudes for the teachers were not statistically significant. Teachers from both high and low participating schools exhibited high levels of knowledge and positive oral health behaviours and attitudes. However, teachers reported some shortcomings in the programme which included lack of: toothbrushes, parental involvement, time for oral health activities, regular workshops and educational materials. Conclusion: The study revealed that learners and teachers from both high and low participating schools had positive oral health knowledge, attitudes and behaviour towards oral health. However, certain socio-environmental factors which are important determinants of oral health could explain the reasons for low participation in oral health programme by some schools. Therefore the Health Promoting Schools approach is a pragmatic way to promote oral health at schools in Swakopmund district because a Health Promoting School has a healthy public policy that creates a supportive environment for oral health, making healthy choices easier.