TikTok, Bilibili, and Xiaohongshu as sources of information on frailty: Cross-sectional content analysis study

Background: The frailty syndrome is among the most prevalent geriatric syndromes, while social media has become a pivotal place for retrieving health information. Objective: The objectives of this study are to investigate the quality of frailty-related videos on major Chinese social media platforms and examine the correlation of the quality with user engagement. Methods: Collect the videos about frailty from TikTok, Bilibili, and Xiaohongshu. Document the general characteristics, uploader information, and content features of each video. Evaluate the quality of each video with the Journal of the American Medical Association (JAMA) benchmark criteria, the Global Quality Score (GQS), modified DISCERN (mDISCERN), and the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). Results: We examined 126 videos in current study. Overall, quality was not promising with a mean JAMA score of 1.1 (SD=0.8), GQS of 2.8 (SD=1.0), mDISCERN of 3.0 (SD=0.8), PEMAT-understandability of 76.5% (SD=15.6%), and PEMAT-actionability of 49.7% (SD=40.2%). Among the platforms, Bilibili had the highest quality videos, and Xiaohongshu had the lowest videos quality. Videos produced by organizations, non-profit groups, medical-related personnel, certified authors, expert monologue, and question & answer is better. The correlation between video quality and user engagement metrics was negligible. Conclusions: The video quality on social media platforms remains inadequate, offering limited utility to users. Frequently, the viewers cannot precisely determine if content from videos is valid or not. First, uploaders need to optimize video quality and second the oversight of platforms should be strengthened to improve public health literacy and raise awareness.