Nova Scotia Strong: why communities joined to embrace COVID-19 public health measures

Objective: To explore Nova Scotian experiences, barriers, and facilitators associated with pandemic public health measures (PHM), including COVID-19 vaccination. Methods: We conducted semi-structured, individual interviews with Nova Scotians between May and August 2021, during the third wave of COVID-19 cases and provincial lockdown. Participants were recruited across the province from three sectors: decision makers, community leaders, and community members using purposive and snowball sampling. Direct content analysis and thematic analysis were used to identify key themes via the Theoretical Domains Framework. Results: The experiences of 30 Nova Scotian interviewees clustered around four themes: Communication of PHM, Responsibly Observing PHM: A Community Coming Together, Navigating PHM, and Vaccine Confidence & Hesitancy. Consistent communication of PHM through briefings with the chief medical officer of health and provincial channels reduced misinformation and encouraged PHM compliance. While adherence was high throughout the province, inconsistent enforcement of these measures proved challenging to individuals navigating PHMs. A high level of COVID-19 vaccine confidence and acceptance was identified, and a strong sense of provincial pride prevailed in keeping COVID-19 numbers and transmission low. Conclusion: This study provides insights into Nova Scotians’ unique experiences with COVID-19 PHM. Provincial public health experts and government leaders communicated PHM with various levels of success, Nova Scotia Strong, a sentiment of unity and communitarianism that sprang from public response to tragic events. Future work should aim to include under-represented communities to facilitate broader inclusion.