What to believe? Conspiracy beliefs and the pandemic

This blog post, the first of two, aims to describe the profile of people with strong conspiracy beliefs, who responded to our surveys in January 2021. This is a preliminary step to analyzing the link between conspiracy beliefs and well-being, which will be the subject of the second blog post on conspiracy theories.

Conspiracy beliefs: a continuum of distrust in the system  

What are conspiracy theories?

Conspiracy theories are false beliefs that attribute the cause of important or serious events to the often malicious intentions of powerful individuals or groups working together in secret.

There are therefore specific conspiracy beliefs, but we can also speak of a "conspiracy mentality," which is the general tendency to subscribe to this kind of belief, regardless of the subject.

Conspiracy beliefs are therefore linked to the level of distrust of governments, public agencies and private companies. We are all on the continuum of distrust in one way or another. It is healthy to question the decisions and actions of institutions that impact our lives. However, for some people, this level of doubt becomes the lense through which they see the world, potentially undermining social cohesion and causing distress. It is therefore appropriate to analyze this worldview without passing judgment.

Profile of people with strong conspiracy beliefs 

Socio-economic status 

Among our sample of 334 respondents, conspiracy beliefs are most strongly associated with education, household income, and pre-pandemic employment status. In total, 13 % have a high level of conspiracy beliefs. There is little difference in the proportion of people with strong conspiracy beliefs between men (14%) and women (12%), nor between different age categories.

In terms of education level, there is a marked difference between those with a university degree and those without. While 6% of those with a university degree display a conspiracy mindset, this proportion rises to 26% and 22% respectively among college or technical school graduates and those with only elementary or secondary education. This difference could be explained by different information consumption habits (e.g., traditional media versus social networks), which in turn could influence the levels of conspiracy beliefs. 

A similar distribution is observed for the different income strata: among those with household incomes of more than $100,000, 5% display a conspiracy mentality (compared to 20% among those earning less than $30,000). Perhaps lower household income could harbor greater distrust of public institutions and governments, as their reality does not always reflect the policy commitments of large institutions to reduce social inequality. Very early in the pandemic, studies had already noted that social inequalities increased the risk of being infected by the virus and of developing a severe form of the disease. It would not be surprising if the most precarious populations felt neglected by the institutions, fueling a certain distrust. 

Finally, 28% of people who were unemployed at the beginning of the pandemic expressed conspiracy ideas. This proportion drops to 15% among retired people and 6% among those who were already employed at the beginning of the pandemic. The precariousness associated with not having a job during a time of uncertainty could thus influence the level of conspiracy beliefs.

Attitudes toward vaccines and politics  

Other variables, more related to attitudes and beliefs, reveal some interesting trends. In January 2021, vaccine intention was strongly associated with conspiracy mindset. In fact, 47% of those who did not intend to - or did not know if they would get the vaccine displayed high levels of conspiracy beliefs, compared to only 6% of those who wanted to receive it. Indeed, these results are consistent with those obtained in other studies. Although our questionnaire did not specifically probe vaccination-related conspiracies, the large difference observed suggests that conspiracy beliefs are part of a larger belief system, characterized by distrust of groups considered powerful or elitist, such as health authorities.

Another interesting finding concerns political positioning on the left-right axis. The further people are positioned to the right of the political spectrum, the more they report a conspiracy mindset (i.e., 41% of those positioned on the right tend to hold a conspiracy worldview, compared to 12% of those in the center, and 8% on the left). In fact, researchers who have observed similar proportions explain that the political ideology of the sources consulted to learn about COVID-19 could influence the level of adherence to conspiracy theories. Even before the pandemic, other researchers have argued that the ideological flavour of a theory determines its tendency to be embraced depending on whether one considers oneself to be right or left wing, but that theories that deny the results of science tend to reinforce more conservative discourses, especially in the US.

A rural-urban divide? 

Interestingly, we notice that in rural areas, small towns and medium-sized towns, 15%, 18% and 24% respectively of participants display a conspiracy, compared to 11% in large cities. This difference could be related to the uneven distribution of right-wing and left-wing supporters within rural and urban areas. Indeed, in our sample, we find twice as many right-wing supporters in rural areas (21%) than in large metropolitan areas (10%).


Throughout this blog post, we have described the profile of individuals with strong conspiracy beliefs in our cohort. Overall, household income, education level, employment status, vaccine hesitancy, political ideas, and living in a rural area appear to be individually associated with conspiracy beliefs. However, some of these factors are also known to have an impact on psychological well-being. In the following blog post, we will further discuss the relationship between conspiracy beliefs and well-being, as well-being is the primary focus of the COHESION study. Stay tuned for more!


Abedi, V., Olulana, O., Avula, V., Chaudhary, D., Khan, A., Shahjouei, S., Li, J., & Zand, R. (2020). Racial, Economic, and Health Inequality and COVID-19 Infection in the United States. Journal of Racial and Ethnic Health Disparities. https://doi.org/10.1007/s40615-020-00833-4

Bertin, P., Nera, K., & Delouvée, S. (2020). Conspiracy beliefs, rejection of vaccination, and support for hydroxychloroquine : A conceptual replication-extension in the COVID-19 pandemic context. Frontiers in Psychology, 11(565128). https://doi.org/10.3389/fpsyg.2020.565128

Romer, D., & Jamieson, K. H. (2020). Conspiracy theories as barriers to controlling the spread of COVID-19 in the U.S. Social Science & Medicine, 263, 113356. https://doi.org/10.1016/j.socscimed.2020.113356

Miller, J. M., Saunders, K. L., & Farhart, C. E. (2016). Conspiracy Endorsement as Motivated Reasoning : The Moderating Roles of Political Knowledge and Trust. American Journal of Political Science, 60(4), 824 844. https://doi.org/10.1111/ajps.12234

Blank, J. M., & Shaw, D. (2015). Does Partisanship Shape Attitudes toward Science and Public Policy? The Case for Ideology and Religion. I, 658(1), 18 35. https://doi.org/10.1177/0002716214554756

Written by Alexandre Coderre and the COHESION editorial team.

COHESION’s Opinion Survey: Here’s What Our Participants Have to Say!

Now that we’ve covered why public engagement is important for public health research, let’s show you how the COHESION study has started engaging participants! The public can engage with a study in many ways: from being informed and consulted, to collaborating, or even partnering with the team. As a first effort, we developed an opinion survey in December 2020,  to consult participants and get feedback on their experiences with the study. The survey included multiple-choice and open-ended questions so that respondents could expand on their answers. Participants suggested ways to improve their experiences, topics for future questionnaires and shared their thoughts on the COHESION study. 

To our surprise, over 350 participants responded to the survey! To let you in on some of our results, here are some interesting findings from the opinion survey.

Why are you participating in the COHESION study? 

73% of respondents expressed that they are participating for the importance of the issue, followed by participating out of curiosity or altruism. Others cited answers such as enjoying surveys, wanting to win a raffle prize, to help study the impacts of the pandemic, or out of interest in research. 

💡 Why is this important?

Knowing why people are participating can give us insight on how to frame our study and how to motivate others to join! 

Did you experience any troubles and doubts completing the questionnaires?

The majority of respondents did not encounter any problems or doubts while completing past questionnaires. Out of the 25% who did experience problems or doubts, only 5% contacted our program coordinator. The main reasons why they did not contact the program coordinator were either that the issue fixed itself, that they lacked the time or that they did not have the necessary information. 

💡 Why is this important?

Knowing how participants are dealing with the platform allows us to make any adjustments that can make their experience easier. It is also important to know that if they do experience issues, the program coordinator should be at hand to help. Considering that only 5% of those who experienced issues contacted the coordinator, steps can be taken to make sure contact  information is clear and readily available.

What about the user-friendliness and structure of the study? 

Respondents were asked to rate a series of statements on the user-friendliness of the COHESION platform on a scale from  “strongly disagree” to “strongly agree”. Statements included: “The platform used for the surveys is user-friendly”, “The surveys are presented in an organized way”, “The questions in the surveys are easy to answer”, “the questions in the surveys are too long”, etc.

Participants found that the length of surveys could be reduced, and that some questions could be formatted differently (ex: include example answers, add a “No answer” option, or allow for short answers). They also commented on the VERITAS questionnaire, the map-based section where participants identify places visited along with social contacts. Comments about VERITAS highlight the difficulty of remembering past places visited, difficulty modifying or deleting places visited, and confusion over what defines a place visited.

💡 Why is this important?

Despite general agreement towards the platform and questionnaires being easy to use, efforts to simplify and shorten our questionnaires and the VERITAS section are underway. Understanding how people experience VERITAS allows us to consider possible biases, like memory bias, when analyzing responses. 

Which themes were most liked?  

We also asked respondents to rate their appreciation for the themes covered by the study, from “strongly dislike” to “strongly like.” Participants especially liked the themes “Daily activities”, “Concerns about the COVID-19 pandemic”, “Health”, “Sleep” and “Vaccines.”  While ratings for the themes “Substance use”, “Child Difficulties”, “Back to School”, “Places visited” and “Food Security” were more neutral or negative.

In this section, respondents also suggested themes for future questions. Some suggestions included: 

💡 Why is this important?

Knowing which themes our participants like or dislike helps us ensure the questions we’re asking are relevant for our participants and allows us to plan for future questionnaires. 

It also allows us to adapt our questionnaires if certain themes are too specific. For instance, the most disliked themes were also those that refer to specific situations that don’t apply to everyone, such as being a parent, going to school, substance use, etc. Finally, the suggestions for future themes help us know what people are curious about, along with some of the worries and situations the pandemic may have created. 

Do respondents download the ETHICA application?

Participants also have the option to download a smartphone application, ETHICA, to complement data from questionnaires. The application supplements the study with regularly collected GPS, sleep, mood, and social contact data. At the moment of this survey, 41% of respondents had downloaded the application. The main reasons for not downloading ETHICA include not owning a smartphone, not feeling as though it is necessary, not having space, having privacy concerns, and troubleshooting issues.

💡 Why is this important?

Knowing the reasons why participants did or did not download ETHICA can give us insight on how to present this phone app as a complement to the study and better explain how this data will be used. 

Are respondents interested in giving us more feedback? 

Finally, 38% of respondents to the opinion survey expressed a desire to continue helping the team improve the study. The majority would like to keep providing feedback through surveys, but many are also interested in participating in small group meetings. 

💡 Why is this important?

Given the amount of interest for more participation, we partnered with the Centre of Excellence on Partnership with Patients and the Public (CEPPP) to help develop a participation strategy. Along with more surveys, we are planning on creating working groups with COHESION participants who wish to help the team. 

What can the Cohesion Study do to improve your experience?

Last but not least, we asked our participants what the team could do to improve their experience. Our participants stated that they would like the team to communicate with them more regularly, would like us to share results and our progress more frequently, and would like to know how their participation benefits the study. We agree!

💡Why is this important?

Starting this Fall, COHESION is launching regular newsletters that will feature preliminary results, news from researchers, and anything COHESION-related! In the meantime, don’t forget to follow COHESION on social media!

So what's next? Over the past months, we’ve taken our participants’ feedback to heart and considerable changes have been made to make our questionnaires simpler and more accessible. Your feedback from the opinion survey has allowed us to improve the study, fine-tune some of the kinks and make it more relevant and enjoyable for current and future participants. But these are just some of the changes we’ve made... we don't want to spoil the surprise! Stay tuned for more news coming this fall! 

Written by Alexie Kim and the COHESION Study Editorial Board, designed by Impakt Scientifik Agency.

Community resilience, COVID-19, and mental health

How can we collectively recover from a health crisis like the COVID-19 pandemic without increasing inequalities? How can we better prepare for future disasters? Well, community resilience might just be part of the answer.

The pandemic has had an impact on all areas of individual, community and societal life, despite the easing of health measures in recent weeks. Long-term effects on mental health are expected, unequally affecting some more than others. Indeed, some groups have been disproportionately affected by the pandemic, especially women, marginalized or homeless people, racialized or immigrant people, as well as children and teenagers.

However, across the country (and around the world!), citizen initiatives, virtual or otherwise, have emerged to offer support and solidarity. At the beginning of the crisis, rainbows and the hashtag #çavabienaller (#everythingwillbeallright) started popping up on windows and doors, as a symbol of resilience - the rainbow after the storm. People created phone lines and Facebook groups to help fellow neighbours and local businesses most hardly hit by the pandemic. There's no doubt that the hardships faced pushed us to find solutions, build stronger ties within our communities, and to face health inequalities, together.

What is community resilience?

Community resilience can be defined as "the ability of community members to adapt to an environment characterized by change, uncertainty, unpredictability and surprise by mobilizing community resources [1]."

Magis (2010)

Community resilience therefore goes beyond adaptation. It also represents the potential for a community to take advantage of disruptions to reinvent itself and develop long-term sustainable practices. Among the collective factors contributing to community resilience, climate change literature emphasizes the importance of:

  • Sense of belonging
  • Place attachment
  • Citizen participation,
  • Local leadership
  • Trust
  • Social cohesion

Last March, the pan-Canadian COHESION study sent questionnaires to participants to understand how these collective factors were related to their mental health and well-being. Initial analyses show a social gradient in community resilience factors, these factors correlating with certain mental health indicators, such as levels of anxiety, depression, and loneliness.

Sense of neighbourhood belonging

Sense of neighbourhood belonging, a contributing factor to community resilience, is one's perception of being integrated into their community [2, 3]. Members of a resilient community have a strong sense of belonging, which increases their active engagement in their community and contributes to positive mental health.

The COHESION study is interested in three mental health indicators: loneliness, anxiety, and depression.

The figures below shows that participants who reported a Very Strong or Somewhat Strong sense of belonging had lower scores for loneliness, anxiety, and depression. Furthermore, participants with a low sense of belonging and low income had higher scores on loneliness, anxiety, and depression.

Figure 1: Sense of belonging in relation to loneliness, anxiety and depression

Figure 2: Sense of belonging in relation to loneliness, anxiety and depression by income

What can we conclude?

These links between neighbourhood belonging and mental health indicators highlight the role that our living environments can play in our ability to cope with adversity. It is important to better understand what features of our neighbourhoods contribute to a sense of belonging, community resilience, and improved mental health and well-being. During the most restrictive periods of the pandemic, local resources such as parks or neighbourhood businesses may have played a critical role, providing opportunities to get active and get some fresh air, or to maintain some social connections. By creating neighbourhoods that promote interactions, with good access to services and infrastructure for all, community resilience is strengthened, and the mental health and well-being of populations promoted. Investing in, transforming and mobilizing our neighbourhoods is key to help respond to major challenges, from a sanitary crisis, to climate adaptation and democratic participation.

Written by Salma Sahil and the COHESION Study Editorial Board


  1. Magis, K. (2010). Community Resilience: An Indicator of Social Sustainability. Society & Natural Resources, 23(5), 401-416.
  2. Kitchen, P., Williams, A. M., & Gallina, M. (2015). Sense of belonging to local community in small-to-medium sized Canadian urban areas: a comparison of immigrant and Canadian-born residents. BMC Psychology, 3(1), 28.
  3. Hagerty, B. M. K., Lynch-Sauer, J., Patusky, K. L., Bouwsema, M., & Collier, P. (1992). Sense of belonging: A vital mental health concept. Archives of Psychiatric Nursing, 6(3), 172-177.

Sleep and housing: Are we all in the same boat?

To understand how housing status is related to sleep during the COVID-19 pandemic, the COHESION study explores whether one’s status as renter or owner, and satisfaction with their housing conditions were associated with sleep duration. Turns out, renters are twice more likely to sleep less than 7 hours per night, compared to homeowners.

To read the full story, check out our blog on Sleep on it !

You can also check out our article on La Presse or listen to our radio interview on Ici Radio Canada.

5 reasons to encourage public engagement in health research

While the crisis sparked worldwide interest in public health among the public, they were not always included in the decision-making process of health mesures. Today, many health researchers, in hospitals, research centres and community organizations, want to shift from the passive role of citizens (being recruited to participate in a study), to the active engagement of the public in the research process (being involved in its planning, implementation and evaluation). 

What is public engagement in research?

Have you ever interacted with a healthcare professional who did not fully understand the realities of your day-to-day life? Have you ever participated in a study where the questions were not relevant to you? Have you ever felt misrepresented by a project or intervention?

Public engagement occurs when citizens "meaningfully and actively collaborate in the governance, prioritization, and conduct of research, and in the synthesis, distribution, sharing, and translation of the resulting knowledge."

Centre for Excellence on Partnership with Patients and the Public (CEPPP)

In other words, public engagement is the inclusion of citizens in the research process and considers their knowledge as valuable throughout the project. Their participation may be needed at different stages of the project. In fact, they may act as consultants, collaborators or even partners.

Here are 5 reasons why you should include public engagement in health research

1) Public engagement builds a sense of community

Engaging with the public is an opportunity to strengthen relationships with the groups and communities your research wishes to serve. Public engagement can also improve participants' trust in researchers and increase their sense of belonging to your study.  

2) Public engagement can highlight blind spots

Public engagement celebrates and values the unique knowledge that each person brings, in the same way we value academic knowledge, to improve the study. The public's knowledge can be very health-specific, such as having health problems, having received treatment, or living with risk factors. It can also be more general, such as living in a certain region, being a parent, or being a racialized person. By engaging with your public, you recognize that each individual is an expert on his or her own health, illness, and social situation. It can even make you aware of knowledge and experiences that you may not share with your audience. Most importantly, this allows you to identify blind spots in your project - and adjust accordingly.

3) Public engagement increases the relevance and usefulness of your research

Making science and research more accessible to the public can remove some of the barriers between researchers and the public. Actively involving citizens throughout your research ensures that it is designed with the relevant groups in mind, and that its objectives are translated into appropriate actions. Ultimately, it can lead to better health care, and improved health and well-being. The ultimate goal is to develop projects and interventions that evolve with, for and by the population.  

4) Public engagement fosters capacity building

Public engagement processes allow those involved to develop new skills and abilities. Teams that include citizens in their projects provide them with the necessary tools and support to empower them. Plus, citizens who collaborate with research teams strengthen their self-confidence as well as skills such as leadership and public speaking.

5) Public engagement reinforces several public health values

Public health is based on several core values such as transparency, openness, autonomy and empowerment, collaboration and reciprocity. These values, central to health promotion, encourage processes that support health improvement and quality research. For example, by being transparent and collaborating - values that increase our trust in institutions - public engagement increases the relevance of research to improve health and well-being (linked to reason #3!).

Overall, including the public and their real-world knowledge is an opportunity to improve research and inform its processes. The COHESION study is currently developing public engagement activities. In December 2020, the team sent out its first survey to better understand participants' experiences. Stay tuned for more blogs on the results of this survey and upcoming public engagement activities!

Written by Alexie Kim and the COHESION Study Editorial Board