PurposeThe purpose of this paper is to understand the role of perceived threat, brand congruence, and social support on consumer coping strategies for a preventative health service.Design/methodology/approachAn online survey of 570 women aged over 50 in one Australian state was conducted (users and non-users of the service). The data were analyzed using structural equation modeling.FindingsA competing models approach reveals that threat on its own is associated with avoidance coping; however, when brand congruence is high, there is an association with active coping. Social support appears to have a buffering effect on threat and is associated positively with active coping and negatively with avoidance coping.Originality/valueThe study findings suggest that threat appeals should be used with caution in increasing participation in transformative preventative health services due to its double-edged sword effect (increasing both avoidance and active coping). When consumers have social support, this results in active coping and buffers avoidance coping. This research offers useful insights for social marketing and transformative service research.