Purpose – The purpose of this paper is to investigate program management teams' views on issues and challenges in managing a large, multi-sectoral child health promotion program in Sweden. Design/methodology/approach – In total, 17 participants representing two autonomous program management teams, one strategic and one operational, were interviewed. Analysis of interview data was complemented with reviews of program documents. Findings – Program management teams identified important issues concerning the program's formal structure, goals, role distribution, and change and dissemination processes, but lacked a shared mental model of the situation. Inter and intra group communication, long- and short-term strategic planning were further areas in need of improvement. While issues and challenges might seem to be agreed upon by the program's change agents, closer inspection reveals variation in key characteristics as well as in perspectives on solutions. Originality/value – Health promotion programs are challenging. Researchers trying to understand program success have focused on particular interventions, contextual factors and program recipients. Less research has focused on the internal processes of teams tasked with wide-ranging change mandates and the effects such processes can have on program outcomes. This study contributes to a deeper understanding on internal processes and mental models of change agent teams.