Health information sharing on social media: quality assessment of short videos about chronic kidney disease

Globally, chronic kidney disease (CKD) had become one of the most common chronic noncommunicable diseases, which played a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease [1]. A 2007 survey study showed that the prevalence of CKD in USA rose from 10.0 to 13.1% [2]. A cross-sectional survey from China suggested that 1 in 10 persons living with CKD—indicate nearly 120 million adults suffering from CKD [3]. Typical features of CKD were irreversible, progressive, and strongly associated with higher cardiovascular risk [4]. Unfortunately, most CKD population had no aware of it. For this reason, interventions to prevent and treat CKD, including the dissemination of health information, early screening, and regular physical examinations, were particularly important.

While most people acknowledged personal responsibility for their own health, a survey in the United Kingdom found that 87% of people chose to go to the hospital when they were only “extremely ill” [5]. This had brought a rigorous trial for our doctors and health educators to improve the public society's awareness of medical and health knowledge and the importance of disease [6]. Current research evidence supported the point that health information dissemination could change health behaviors, thereby greatly improving the early diagnosis and prevention of diseases [7]. The diversified development of social media, such as Tik Tok [8‐10], Douyin, and Kuaishou, etc., had made the dissemination of public health information develop by leaps and bounds in China and around the world [9, 11, 12]. Similarly, the nephrology community, as one of multiple department of diseases, needs a creative way to popularize health knowledge to improve the world's kidney health problems [13].

Improving the level of education and training of public health personnel was one of the policy priorities according to “Healthy China 2030” blueprint which launched by Chinese government in 2016 [14, 15]. Moreover, popularization of health information was one of the important contents of the work for the association of nephrology. Due to the characteristics of fast dissemination, wide audience, intuitive and vivid, popularization through short videos had rapidly developed into the new main battlefield of health information dissemination. High prevalence and low awareness were the main obstacles to the prevention and treatment of CKD [3, 16‐19]. Professional popularization of kidney disease, such as encouraging and correctly guiding social media to carry out high-quality kidney disease health information dissemination under this new situation, would help to improve the public's awareness of CKD, early screening, early diagnosis and prevention strategies for CKD [20‐22]. In this study, features of uploaders major in nephrology and their works published on short video apps were investigated and analyzed to explore the current situation of professional popularization of kidney disease on social media in China.

The popularization played an important role in promoting healthy lifestyles and disease information dissemination [25], which could improve the public’s awareness of diseases and the overall level of prevention and treatment of disease in China. Popularization of health information had been included in the construction goals and related work plans of the "Healthy China 2030" Planning Outline [26]. Recently, health information dissemination was affected by the pandemic of COVID-19 greatly [27]. Due to the characteristics of strong dissemination and acceptance, Internet especially social media platforms, such as short video apps, had gradually become one of the main fields of health information dissemination [28, 29], and played an increasingly important role in sub-healthy or potentially diseased populations [30, 31].

The construction of the prevention and treatment system for CKD was inseparable from health information dissemination. Through popularization of health information, strengthening the public's awareness and attention to CKD, early detection and diagnosis of CKD, and understanding of CKD prevention and treatment strategies were extremely important for CKD management [32‐34]. The CKD prevention and control work plan in Taiwan, China since 2002 had been carried out through more than ten years, which had significantly reduced the incidence of end-stage renal disease (ESRD) [21]. Therefore, it had significant academic and social value to encourage and carry out health information popularization of kidney disease [35‐37]. At present, short videos popularization of health information about kidney disease was in the ascendant. This study investigated the status of short video type of health information dissemination on social media platforms and provided a basis for the society to encourage and formulate a health information popularization work.

Currently, uploaders who share health information on Douyin app were demanded to provide certification materials for working in tertiary A hospitals for doctor’s identification. This study found that most uploaders (63.1%) did not have doctor identification, indicating that nephrologists in tertiary A hospitals with high professional level lacked enthusiastic to participate health information popularization of kidney disease. It also showed that the quality of some short video works needed to be improved in the survey. More than half of the uploaders uploaded their first work within 6 months during the survey, and most of them started to carry out popularization of health information work during the COVID-19 pandemic. This was in line with the drastic increase in public demand for health knowledge in crisis situations. Nearly a quarter of the uploaders had not updated their works more than a month, indicating that there was a high probability that they would withdraw from this work. 60% of the uploaders had less than 10,000 follows, and their influence was relatively weak. The results of this survey showed that kidney disease information popularization of short video on social media emerged spontaneously and was still in the preliminary stage. More senior nephrologist should be encouraged to participate in kidney disease popularization. Special training and promotion should be carried out to meet the public's demand for renal health knowledge.

Awareness, popularity, utility, validity, and quality are the five main elements of health information dissemination. CKD volunteers and nephrologists were invited to evaluate the quality of these works. Most works had low scores for “awareness” and high scores for “utility”, indicating that the topic selection of most health information was appropriate and helpful for improving the public’s information of kidney disease. It also showed that the development of health information popularization satisfied public’s demands. It was also found that most of the videos had relatively high scores for “popularity”, indicating that short video works were indeed a form of medical popularization that spreads quickly and was popular for publics. However, in the scoring of the professionalism of nephrologists, the “validity” and “quality” scores of some works were relatively low, indicating that quality of these works was uneven, and some works were even misleading to a certain extent. The results of this research showed that health information popularization still needed to be properly guided, so that high-quality ones occupied the main battlefield.

The limitations of this study were as follows: First, only the uploaders in Douyin platform were analyzed, those uploaded popularization works in other short video platforms were not included. In addition, language or ethnic differences might produce different results since this study only assessed the health information quality of Chinese short videos. Last but not least, quality of works was assessed by five CKD volunteers and three nephrologists, and bias might exist for their own different knowledge. In future research, we will call for more extensive cross-language comparative studies across different social media apps using more precise assessment tools.

This study assessed features of 65 kidney disease popularization uploaders and quality of their 3973 short video works on Douyin app in China. The results showed that most uploaders did not obtain doctor’s identification. Awareness, popularity, and utility of these works was satisfactory, although validity and quality varied across different uploaders. The results suggested that more nephrologists should be encouraged to participate in kidney disease popularization and the uploaders should be specificized.