In postulating the need for a more inclusive conceptualisation of knowledge that improves the practice of prevention science in mental health programs, Rowling (2008) makes a case for acknowledging the validity of the disparate research and practice cultures from both health and education. A review of literature using narrative synthesis was undertaken to explore the differing research and practice cultures. Three recurring themes were identified at the interface of these differing traditions: individual versus group orientation, school leadership and change in schools. These are perceived differently due to the mental models being used by program developers and education professionals. These alternative views consistently emerge in relevant evaluation reports. It is proposed that the identified problems of sustainable implementation in schools are not restricted to health-related programs, but are consistent across interventions. Building on this analysis, several actions are suggested that will increase the capacity to develop, implement and sustain universal and evidence-based promotion and prevention activities in Australian schools.