The document discusses factors that can positively or negatively impact health education, including predisposing, enabling, and reinforcing factors. It identifies several environmental factors like natural surroundings, social surroundings, and climatic/atmospheric conditions. Physical factors include a student's health, nutrition, and physical defects. Emotional factors refer to stress levels and sleep habits. The teacher's method of teaching and managing students is also identified as an important factor. The document asks the reader to identify possible barriers to effective oral hygiene promotion in their local community. It notes that khat chewing is a major problem in the Somali community that negatively impacts oral health, and it is difficult to convince people to stop chewing khat for the sake of oral