Abstract
Cardiovascular disease (CVD) remains the leading cause of death worldwide. Early detection of CVD risk factors through preventive screening programs can substantially reduce adverse outcomes, yet participation rates in such programs remain suboptimal. In this paper, we examine whether perceived social cohesion between the sender and the recipient of an invitation to a free cardiovascular health check affects health beliefs and participation intentions. Using a survey experiment on a representative sample of 2,588 individuals aged 40–74 in England—the target group for the NHS Health Check program—we randomly assign participants to receive an invitation message from a peer who either shares or does not share their social norms. We measure the impact of perceived social cohesion on health beliefs, including perceived susceptibility, severity and benefits as predicted by the Health Belief Model. The manipulation successfully altered perceptions of social cohesion, and estimated effects are directionally consistent with the hypothesis that cohesive peer messages enhance message effectiveness. In particular, our results indicate that cohesive peer messages impact on health beliefs leading to a higher perceived threat and benefit of checking. The modified beliefs, then, increase the willingness to undergo CVD health checks. Finally, we find that the degree to which beliefs can be modified may depend on the personality of the recipient and her/his risk aversion.