Purpose: This case study aimed to examine the factors influencing the implementation of health promotion (HP) policies and programs in secondary schools and the consequences for professional assistance. Design/methodology/approach: Group interviews were held in two schools that represented the best and worst case of implementation of a health promotion program "Schoolbeat") in the Southern Limburg region. Both schools were represented by the school manager, the health care coordinator and their school health promotion (SHP) advisor. The main purpose of the group interview was to describe the organization of HP in the school. Findings: Efforts to improve organizational aspects like change management, collaborative support and project management contributed to the implementation of HP. Practical implications: Based on these results the authors advise SHP advisors to focus more on the organizational aspects of HP in schools. Originality/value: This study contributes to the discussion about the tasks of HP professionals assisting secondary schools. Results show that effective assistance in shaping school health promotion requires competencies that go beyond organizing practical HP activities. HP professionals assisting schools need skills covering many aspects of the field, ranging from professional assistance for the process of implementing HP to organizational skills to advise and guide schools on the organizational changes needed for the implementation of HP. (Contains 2 tables.)