Our best campaigns may not be written by us

Min (a composite character) has peeled shrimp in a seafood plant for three years. His shifts run twelve hours, with one day off a week. Every morning his hands are so stiff he can barely hold a coffee cup. In the staff room there is a poster of stretching exercises, written entirely in Thai. Min walks past it every day, then buys painkillers from the shop outside the gate.

Nothing on that poster is wrong. Every line may be accurate. But it was designed by people who never asked Min a single question.

Min is not alone

Min is one of about 1.71 million workers from Myanmar employed in Thailand in 2023 [1]. Compared with workers from Cambodia (about 400,000), Laos (about 230,000) and Vietnam (about 1,400) in the same year, workers from Myanmar made up roughly three in four of those from the four countries combined [1–4]. Communication designed without this group in mind overlooks most of the country's migrant workforce.

In a 2026 study in which a research team including researchers from our centre co-designed an exercise programme with Myanmar workers at a seafood plant, all 29 workers in the sessions reported hand symptoms. Twenty-five of them (86%) had morning stiffness that affected life outside work, and 23 (79%) bought painkillers at least once a week.

Those figures say more than that people are in pain. They say this group is already trying to look after itself. Nobody had designed an option that fits the life they actually live.

The same picture shows up nationally. The ILO's migration report states that in February 2024 about 2.54 million migrant workers were eligible for the Social Security Fund, but only about 1.30 million were enrolled. In the Migrant Health Insurance Scheme, about 480,000 were eligible and about 250,000 enrolled [5]. That is roughly half in both schemes. The gap has many causes, not communication alone, but it shows that rights that exist on paper have yet to reach the daily lives of many people.

The constraints people name are the design brief, not obstacles

What the research team did differently from that poster was simple: they talked with workers in Myanmar language, scheduled sessions around twelve-hour shifts, took consent away from management, and listened to what the workers wanted.

The answers came back as very specific conditions. The exercises had to fit a dormitory-sized space, need no equipment, happen outside working hours, and never cost earnings, because everyone sends money home. Twenty-six of the 29 used Facebook every day and wanted video demonstrations rather than handouts, because they could watch them without supervisors seeing. They also turned down compulsory workshops on their one day off.

Those conditions became the brief for a 12-exercise, four-week programme. When four international physical therapists reviewed it, the programme scored highly on content validity. Listening to the workers did not cost clinical quality.

For communicators the lesson is direct. A channel your audience already uses, and can use privately, matters more than the channel your organisation is comfortable with.

Let people inside the group carry the message

An earlier study by Smith Boonchutima and colleagues (published in 2019, with data collected in 2017, before the centre was founded) tested this with HIV risk communication at a factory in Samut Sakhon. The team designed the campaign from focus groups with 16 workers and interviews with ten government and NGO officers, then had health volunteers recruited from among the workers deliver it to 400 workers over two weeks.

After the campaign, knowledge of HIV rose significantly, so did workers' confidence that they could protect themselves, and their stage of change for condom use and HIV testing moved forward. The one thing that did not move was their sense of personal risk.

That last result is the most interesting. Many health campaigns start by making people afraid. Here, behaviour changed without anyone feeling more at risk. The researchers concluded that the workers' part in designing the campaign was what made it work.

Order matters: trust comes before materials

The third study, by the same team as the HIV study (2022), turned these field lessons into a six-step model called ENGAGE-A3 and asked ten experts in communication, public health and migration to rate it. It scored 4.26 out of 5 overall. The two steps tied for the highest score, 4.45, were earning trust and gamification; getting local help scored 4.36.

The usable point is the order. Communication with vulnerable groups usually starts by producing materials, yet the steps the experts valued most happen before the first material exists. It is also worth saying plainly that evaluation scored lowest of the six steps (4.18), which suggests that even experts weigh measurement less than the other steps.

What this evidence can and cannot tell you

All three studies are small. The exercise study is a co-design with people from one factory; it has not yet tested whether the exercises reduce symptoms. The HIV study comes from one factory and measures behaviour through self-reports. The six-step model was rated by experts rather than tested against health outcomes. What the three agree on is a way of designing, not a guarantee of results.

The national figures come from an ILO report via Statista and cover workers in the official system, so the real numbers may be higher. The enrolment gap has many causes, such as type of employment and cost, and should not be read as the result of communication alone. The shares quoted were calculated by our centre from the figures in the report.

Try it on your next project

• Before you write the brief, hold one session with your audience, in their language, at a time they are actually free, not when the office finds it convenient.
• Write the conditions they give you into the brief as requirements: it must work on a phone, it must finish in three minutes, it must not take their day off.
• Find people inside the group whom others trust, let them carry the message, and plan how you will measure results from day one, not after the campaign ends.

Our centre works this way with organisations too, for example in a service-design workshop with Thailand's Department of Disease Control that focused on targeted communication.

If your organisation is designing communication for hard-to-reach groups, the Center of Excellence in Communication Innovation at Chulalongkorn University's Faculty of Communication Arts would be glad to talk and share what we have learned.