A plan to test whether twelve exercises, delivered as a game inside a Facebook group, can reduce work-related pain among migrant workers

Myanmar migrant workers in Thailand's seafood industry develop musculoskeletal disorders from repetitive work, but conventional health communication rarely reaches them across language and cultural barriers. This protocol sets out a plan to develop and test a health communication package built for their language, culture and the actual nature of their work.

The study runs in two phases. Phase 1 develops the package through focus group discussions of 8 to 10 participants until saturation, key informant interviews of 40 to 60 minutes each and expert review, and adapts an assessment form starting from the Nordic Musculoskeletal Questionnaire. Phase 2 implements it with a target of 400 participants — an expected 360 after a 10% dropout allowance — measured before and after with the validated form. The trial was registered with the Thai Clinical Trials Registry in May 2024.

• The package is twelve exercises, chosen with health specialists to target the body areas the work affects most, such as the neck and back.
• The channel is a Facebook group rather than an app that has to be installed. The inclusion criteria require participants to log in at least once a week — a deliberate choice to work where the audience already is.
• The game mechanics are specified in advance: informational posts three times a week, quizzes three times a week on alternating days, and a weekly challenge. Points are awarded for participation (1 for a reaction, 2 for a comment, 1 for completing a quiz and 2 for answering correctly, 5 for joining the weekly challenge), with a leaderboard showing only the most active 10%.
• What will be measured is knowledge, awareness and self-reported musculoskeletal symptoms, compared before and after with t-tests or ANOVA, alongside engagement tracked from actual behaviour in the group.
• The word “ethical” in the title refers to conditions written down in advance — informed consent, confidentiality, and a cap on compensation of no more than 200 baht so that payment does not become pressure to take part.

The plan addresses the problem that has dogged health communication with migrant workers: the material never reaches the people it is for. Two things here are directly reusable. The first is the channel decision — not building an app, but going where the audience already is. The second is writing the incentive design and the payment ceiling down before recruitment starts, which makes it possible to check afterwards that participation was genuinely voluntary. The companion study that has already reported results covers designing the exercises together with the workers themselves.