Conspiracy Beliefs, Institutional Mistrust, and Health‐Related Behaviours During the COVID‐19 Pandemic in Burkina Faso: A Mediation Analysis

Background No study has yet examined the conjoint role of institutional trust and COVID‐19 conspiracy beliefs on compliance with COVID‐19 preventive behaviours among populations of African countries. This study aims to deepen the understanding of the relationship between institutional mistrust, conspiracy beliefs, and health‐related behaviours in the context of an African country during the COVID‐19 pandemic. Methods A cross‐sectional research design was employed, and a paper‐based survey using face‐to‐face interviews was conducted among the general adult population of Burkina Faso, collecting data on institutional mistrust, conspiracy beliefs, health‐related behaviours (i.e., vaccination attitudes, agreement to sanitary measures, and containment‐related behaviours), information‐seeking behaviours (including traditional and digital sources of information), and negative sentiments. We defined a conceptual model according to the existing literature. A mediation analysis was employed to examine the direct effect of institutional mistrust on health‐related behaviours and its indirect effect through conspiracy beliefs endorsement. Additionally, the effects of information‐seeking behaviours and negative sentiments on mistrust and conspiracy beliefs were explored. Results We find that institutional mistrust had a direct negative effect on all health‐related behaviours and an indirect effect through conspiracy beliefs which themselves had a direct negative effect on protective behaviours. The partial mediation accounted for 12% (agreement with sanitary measures) to 34% (vaccination attitudes) of the total effect of institutional mistrust on health‐related behaviours. Information seeking on traditional media and negative sentiments had positive effects on conspiracy beliefs and institutional mistrust, respectively. Conclusions Our findings underscore the need for medium‐to long‐term policies aimed at restoring and perpetuating trust in institutions and curbing conspiracy beliefs for fighting future pandemics. In short term, health promotion campaigns should be channelled through the sources of information in which individuals have the greatest confidence such as religious and traditional leaders.