Between Resistance and Adaptation in COVID-19 Times: The Outbreak Daily Prevalence Moderates the Association between Conspiracy Thinking and Adherence to Government Protocols

Objectives. Conspiracy thinking has played a significant role in shaping public responses to the COVID-19 pandemic and has influenced citizens’ adherence to government protocols, including reluctance to receive vaccination and adherence to public health measures. However, little attention has been paid to how contextual factors, such as the severity of the pandemic, interact with these beliefs. This study examines how the prevalence of the pandemic, defined as the ratio between the number of cases and swabs each day, moderated the relationship between conspiracy thinking and adherence to public health norms. Methods. We conducted a secondary analysis of the ResPOnsE COVID-19 project, a rolling cross-section two-wave survey of Italian adults (N = 5,421) conducted between March and December 2021. Using a multilevel modelling approach, with data nested by day of data collection, we analysed the association between conspiracy beliefs, reluctance to receive COVID-19 vaccination and resistance to restrict personal freedoms, interacting conspiracy beliefs with daily variations in pandemic prevalence. Results. Conspiracy beliefs were positively associated with reluctance to receive COVID-19 vaccination and resistance to restrictions. The prevalence of the pandemic moderated these relationships: As the pandemic prevalence increased, conspiracy believers became more reluctant to get vaccinated, but more accepting of restrictions of freedom. Conclusions. Our results emphasize the context-dependent nature of the consequences of conspiracy beliefs. Rather than uniformly rejecting all public health measures, conspiracist citizens adjust their responses depending on contextual factors. These findings challenge simplistic representations of their attitudes and emphasize the need for dynamic public health communication strategies.