Objectives Communication is central to the implementation and effectiveness of public health measures. Informed by theories of good governance, COVID-19 pandemic public health messaging in 3 Canadian provinces is assessed for its potential to encourage or undermine public trust and adherence. Methods This study employed a mixed-methods constant comparative approach to triangulate epidemiological COVID-19 data and qualitative data from news releases, press briefings, and key informant interviews. Communications were analyzed from January 2020 to October 2021 in Nova Scotia, Ontario, and Alberta. Interview data came from 34 semi-structured key informant interviews with public health actors across Canada. Team-based coding and thematic analysis were conducted to analyze communications and interview transcripts. Results Four main themes emerged as integral to good communication: transparency, promptness, clarity, and engagement of diverse communities. Our data indicate that a lack of transparency surrounding evidence and public health decision-making, delays in public health communications, unclear and inconsistent terminology and activities within and across jurisdictions, and communications that did not consider or engage diverse communities’ perspectives may have decreased the effectiveness of public health communications and adherence to public health measures throughout the COVID-19 pandemic. Conclusion This study suggests that increased federal guidance with wider jurisdictional collaboration backed by transparent evidence could improve the effectiveness of communication practices by instilling public trust and adherence with public health measures. Effective communication should be transparent, supported by reliable evidence, prompt, clear, consistent, and sensitive to diverse values. Improved communication training, established engagement infrastructure, and increased collaborations and diversity of decision-makers and communicators are recommended.

Objectives Communication is central to the implementation and efficacy of public health measures. This paper explores public health messaging in Canada during the COVID-19 pandemic, assessing its potential to encourage or undermine public trust and adherence. Methods This study analyzed data from two primary sources. The first is government press briefings, associated press releases, and public health directives from January 2020 to October 2021 in Nova Scotia, Ontario, and Alberta. The second data source is 34 semi-structured key-informant interviews with public health actors across Canada. A directed qualitative content analysis approach was employed to analyze press briefing transcripts. Team-based coding and thematic analysis were conducted to analyze interview transcripts. Results Three main themes emerged from the data: inconsistency, lack of clarity, and need for engaged communication practice. Ambiguous and inconsistent language practices across and within jurisdictions were common. Clear language that combines scientific evidence with an appeal to social and emotional factors was lacking, specifically in relation to nuanced matters. Communication practices revealed a disconnect between local communities and jurisdictional communicators who often lacked sensitivity and understanding of local concerns and values. Conclusion Effective communication must be consistent, clear, and community-driven. Increased federal leadership surrounding public health communication, further jurisdictional collaboration, improved communication training, established engagement infrastructure, and increased diversity of decision-makers and communicators are suggested to improve the effectiveness of communication practices by instilling public trust and thus adherence with public health measures.