Objectives: The study explores the relationships among teachers’ health representations, their ideas about health promotion, their working conditions and their involvement in health-promotion activities at school.

Methods: A questionnaire was administered to 107 teachers in 86 schools in Milan (Italy). The questionnaire was structured in four parts: teachers’ involvement in health-promotion programmes, teachers’ representations of health and their ideas regarding methods for promoting health; some dimensions of teacher’s job characteristics (job overload, work group, collaboration with relatives); burn-out and job satisfaction; socio-demographics data of teachers and characteristics of the schools.

Results: The results show that teachers have ambiguous health representations; however, the traditional idea of health as absence of illness was prevalent among the teachers surveyed. Regarding health-promotion activities, the teachers seemed to prefer health education programmes based on informative techniques. Some representations of health were connected to the importance that teachers attributed to health promotion and to teachers’ participation in health-promotion activities. Teachers’ working conditions appear not to be related to their involvement in health promotion.

Conclusions: The majority of teachers involved in this study remained substantially linked to health education models and have not switched to the health-promotion approach. This could be related to teachers’ health representations. To encourage the adoption of the health promotion approach at school, changing teachers’ health representations could be a first step.