Building Care That Fits Its People: Insights from Social-Media–Enabled Community-Based Rehabilitation in Thailand

Paper Title

Building Care That Fits Its People: Insights from Social Media–Enabled Community-Based Rehabilitation in Thailand

Publication Info

• Topic area: Social media interventions for community-based rehabilitation in low-resource settings.
• Keywords: Community-Based Rehabilitation (CBR), social media, digital health, low-resource settings, caregiving, cultural adaptation, participatory design, Thailand, rural healthcare, Human-Computer Interaction (HCI).

Background and Problem

• Problem / challenge: Existing digital health interventions in low-resource settings often rely on transmission models that focus on delivering information, ignoring the relational and cultural dynamics of caregiving. This approach limits their effectiveness in complex, community-driven care systems.
• Significance: Addressing these gaps is critical for improving rehabilitation outcomes in low-resource settings like rural Thailand, where formal healthcare infrastructure is limited, and caregiving relies heavily on families and community volunteers.
• Motivation and related work: Prior research has shown the potential of Community-Based Rehabilitation (CBR) and digital tools in healthcare but has largely overlooked how these tools integrate into the socio-cultural and relational fabric of caregiving communities. This study builds on these insights to explore how social media can support CBR in culturally grounded ways.

Solution

• Proposed approach: A multi-platform social media intervention co-designed with stakeholders to support Community-Based Rehabilitation (CBR) in rural Chiang Mai, Thailand.
• Novelty:
  1. Demonstrates how communities appropriate digital tools for caregiving beyond simple information consumption.
  2. Introduces the concept of "infrastructures of repair" to describe socio-technical arrangements that support rehabilitation and redistribute care work.
  3. Highlights the interplay between clinical protocols and cultural practices, such as Buddhist merit-making and family hierarchies.
  4. Provides a participatory framework for designing culturally resonant digital health interventions in low-resource settings.
• Procedure and key techniques:
  1. Conducted need-gathering workshops with 39 stakeholders to identify caregiving challenges.
  2. Co-created 30 videos and complementary materials with a multidisciplinary team, ensuring cultural and clinical relevance.
  3. Deployed content across Facebook, YouTube, TikTok, and LINE, integrating online and offline dissemination strategies.
  4. Evaluated the intervention through platform analytics and semi-structured interviews with 28 participants, including caregivers, patients, and health volunteers.

Results

• Concrete findings:
  • The intervention reached over 110,000 impressions on Facebook, 1 million on YouTube, and 86,000 views on TikTok.
  • Women dominated engagement (e.g., 79.3% on LINE), and older users (55+) were most active on YouTube and LINE.
  • Key content categories included Food (4,648 views), Mental Health Care (4,530), and Rehabilitation & Exercise (4,223).
  • LINE achieved a 29.42% click-through rate, indicating high responsiveness among older users.
• Advantage over baselines: The intervention moved beyond information delivery to support relational and cultural caregiving practices, such as using videos to mediate family hierarchies, integrate rehabilitation into Buddhist merit-making, and foster offline peer networks.
• Experiments / evaluation:
  • Mixed-methods approach combining platform analytics and semi-structured interviews.
  • Participants included 1 patient, 12 caregivers, 6 Village Health Volunteers (VHVs), and 9 healthcare professionals.
  • Metrics assessed impressions, reach, engagement, and offline impacts like trust-building and emotional resilience.
• Limitations and future work:
  • Limited generalisability to other cultural contexts.
  • Unclear long-term impact due to a five-month deployment period.
  • Digital accessibility barriers, such as shared devices and connectivity issues, need further exploration.

Summary

This study demonstrates how a multi-platform social media intervention can support Community-Based Rehabilitation (CBR) in rural Thailand by integrating clinical protocols into local cultural and relational practices. The intervention reached over 110,000 users and was appropriated by communities to address caregiving challenges, mediate family dynamics, and sustain emotional resilience. It highlights the importance of designing "infrastructures of repair" that align with existing care systems and cultural values. Future work should focus on long-term impacts, digital accessibility, and co-designing with diverse stakeholders to further adapt interventions to local contexts.