Health promotion as a behavioural challenge: are we missing attitudes?

Despite the considerable financial and organizational resources of health promotion campaigns, their effectiveness in tackling current health problems is limited. In the following commentary, we argue that health promotion is best understood as a behavioural challenge. Behaviour can be understood in terms of three aspects: knowledge, skills and attitudes. While knowledge and skills have received adequate attention, the attitudinal approach has been significantly underutilized. To this end, we have used the examples of prevention of H1N1 transmission, hand washing in hospitals and prevention of cervical cancer to elucidate our points. We also provide recommendations of how the attitudinal approach can enhance the effectiveness of health promotion interventions.