Quality, source transparency, information reliability, and domain coverage of short video-based information on feeding guidance for people with dysphagia: a cross-sectional study on 4 major Chinese social media platforms

Abstract

Background Standardized feeding guidance is valuable for people with dysphagia, helping prevent aspiration, improve nutritional status, and enhance quality of life. In recent years, short-video platforms have become a key avenue for the public to access health information, providing people with dysphagia with a convenient channel to learn about feeding management. However, the quality of online health information varies considerably, making it difficult for patients to effectively distinguish reliable information from potential misconceptions, which may negatively impact clinical outcomes. Objective This study aims to systematically evaluate feeding guidance content for dysphagia on mainstream Chinese short-video platforms by analyzing its quality, the transparency of its information sources, the reliability of the information, and its coverage of relevant domains. Method This study retrieved and included 278 short videos on feeding guidance for dysphagia as research samples from four major Chinese mainstream short video platforms: Rednote, Bilibili, Douyin, and Kwai. Two independent rehabilitation therapists specializing in dysphagia rehabilitation evaluated the domain coverage of video content using 10 criteria derived from relevant clinical guidelines and expert consensus documents on feeding guidance for people with dysphagia. We assessed the transparency of the video's information sources, overall quality, and information reliability using the Journal of the American Medical Association (JAMA) Benchmark Criteria, the Global Quality Score (GQS), and the modified DISCERN (mDISCERN) Score. We also compared video data from different content providers and upload platforms. Results Based on the identity of the video uploader, videos were classified into seven categories, comprising four categories of healthcare professionals (physiatrists, rehabilitation therapists, rehabilitation nurses, and healthcare professionals in related clinical departments) and three categories of non-healthcare professionals (non-profit organizations, individual science communicators, and people with dysphagia). The results indicated that the overall quality of feeding guidance videos for people with dysphagia was generally low (GQS median = 2, IQR = 2–3). The impact of uploader identity varied across assessment dimensions: healthcare professionals scored significantly higher than non-healthcare professionals on both the JAMA score ( P < .001) and the mDISCERN score ( P < .001), although the inter-group difference in the GQS score was not statistically significant; rehabilitation nurses performed best on the GQS dimension, healthcare professionals in related clinical departments achieved the highest scores on the mDISCERN dimension, and people with dysphagia scored the lowest on the JAMA dimension. Differences among platforms also exhibit dimensionality dependence: the GQS scores showed minimal variation, with only Bilibili and Kwai exhibiting a statistically significant difference (adjusted P < .05, r = .376); the JAMA scores demonstrated moderate variation, with Rednote, Douyin, and Bilibili all significantly outperforming Kwai (adjusted P < .0001, r = .387; adjusted P < .0001, r = .551; adjusted P < .05, r = .288); the mDISCERN scores showed the most pronounced differences ( ε 2 = .503), with Douyin significantly surpassing Rednote, Bilibili, and Kwai (adjusted P < .0001, r = .771; adjusted P < .0001, r = .757; adjusted P < .0001, r = .595). In terms of domain coverage, food adjustment (77%) and swallowing posture adjustment (52%) had relatively high coverage rates. In contrast, high-risk domains such as medication management (4%), nutritional management (21%), and oral care (17%) exhibited severe supply gaps. Conclusion Among current mainstream short-video platforms in China, the overall quality of educational content on feeding guidance for people with dysphagia still requires improvement. The reliability of this information depends on both content creators' professional backgrounds and platform ecosystems. The existing short videos currently lack sufficient support for safe decision-making and standardized self-management among people with dysphagia. There is an urgent need to implement coordinated interventions that incorporate professional expertise, platform algorithm governance, and multidimensional quality assessments to support the standardized development of a health science communication environment.