Information Quality of Short Videos on Esophageal Cancer Risk Factors on Douyin and TikTok: A Cross-Sectional Study of Social Media-Based Risk Communication With a Focus on Warnings About Hot Foods

Information Quality of Short Videos on Esophageal Cancer Risk Factors on Douyin and TikTok: A Cross-Sectional Study of Social Media-Based Risk Communication With a Focus on Warnings About Hot Foods | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Information Quality of Short Videos on Esophageal Cancer Risk Factors on Douyin and TikTok: A Cross-Sectional Study of Social Media-Based Risk Communication With a Focus on Warnings About Hot Foods Guicheng Pan, Lingling Geng, YongXiang Song, KHAMMALA AKOUY, Junliang Ma This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9447825/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background Short-video platforms are increasingly used for health information seeking and have become important channels for digital health communication. However, evidence on the quality of short videos addressing esophageal cancer risk factors remains limited, particularly across paired platform ecosystems such as Douyin and TikTok. Differences in creator composition, audience engagement, and the dissemination of culturally relevant warnings about very hot foods have not been adequately characterized. Objective To evaluate the information quality of short videos related to esophageal cancer risk factors on Douyin and TikTok, compare creator composition, user engagement, and dissemination of warnings about very hot foods across platforms, and identify factors associated with higher-quality content. Methods On March 15, 2026, searches were conducted on Douyin and TikTok using the keywords #食管癌, #食道癌, and esophageal cancer. Publicly accessible videos were consecutively collected according to each platform’s default ranking using newly registered accounts on separate devices with cleared caches and browsing histories. Extracted variables included video duration, number of followers, likes, comments, shares, content theme, creator type, presentation format, and whether the video mentioned warnings about very hot foods. Content themes were categorized as treatment, diagnosis, prevention, etiology, or other. Video quality was assessed using the modified DISCERN (mDISCERN) instrument and the Global Quality Scale (GQS). Two reviewers independently rated each video, and the mean score was used for the primary analysis. Interrater agreement was evaluated using weighted Cohen kappa. Statistical analyses included the Mann-Whitney U test, chi-square test, Spearman rank correlation, principal component analysis, and ordinal logistic regression. Results A total of 516 videos were included, comprising 279 from Douyin and 237 from TikTok. Interrater agreement was high (weighted kappa = 0.969 for mDISCERN and 0.928 for GQS). Douyin videos were longer than TikTok videos [91 (66–134) s vs 56 (19–92) s, P < 0.001], whereas TikTok videos had higher median numbers of likes, comments, and shares (all P < 0.001). Within the sampled results, Douyin videos scored higher than TikTok videos on both mDISCERN and GQS [mDISCERN: 3.0 (2.0–4.0) vs 1.0 (1.0–2.0); GQS: 4.0 (4.0–4.0) vs 3.0 (3.0–4.0); both P < 0.001]. Douyin content was primarily posted by medical professionals and medical institutions (70.3% and 24.4%, respectively), whereas TikTok content was predominantly posted by lay individuals and science communication creators (54.4% and 24%, respectively). Warnings about very hot foods were substantially more common on Douyin than on TikTok [31.9% (89/279) vs 7.2% (17/237), P < 0.001]. Video duration was positively correlated with both GQS and mDISCERN (rho = 0.348 and rho = 0.330, respectively; both P < 0.001). Ordinal logistic regression showed that longer video duration was a stable positive correlate of higher quality ratings, whereas TikTok was significantly associated with lower quality categories. Conclusions In this cross-sectional comparison of social-media-based esophageal cancer risk communication, Douyin videos had higher information-quality scores than TikTok videos within the sampled search results. Although TikTok videos showed greater user engagement, engagement metrics did not reliably reflect content quality. The observed differences appeared to be shaped jointly by creator composition, language environment, audience ecosystem, and platform governance. These findings support stronger expert participation, information transparency, and platform-level quality signals in digital health communication on short-video platforms. digital health social media Douyin TikTok esophageal cancer health information quality risk communication Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 27 Apr, 2026 Editor invited by journal 25 Apr, 2026 Editor assigned by journal 23 Apr, 2026 Submission checks completed at journal 23 Apr, 2026 First submitted to journal 17 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9447825","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":634122813,"identity":"73692f11-1788-4f88-8bd1-6b9f9fd21340","order_by":0,"name":"Guicheng Pan","email":"","orcid":"","institution":"Affiliated Hospital of Zunyi Medical College","correspondingAuthor":false,"prefix":"","firstName":"Guicheng","middleName":"","lastName":"Pan","suffix":""},{"id":634122817,"identity":"98111dd1-843b-411a-bc63-b75b6b80de54","order_by":1,"name":"Lingling Geng","email":"","orcid":"","institution":"Affiliated Hospital of Zunyi Medical College","correspondingAuthor":false,"prefix":"","firstName":"Lingling","middleName":"","lastName":"Geng","suffix":""},{"id":634122839,"identity":"537b093a-b430-432d-8936-ce4043bc812c","order_by":2,"name":"YongXiang Song","email":"","orcid":"","institution":"Affiliated Hospital of Zunyi Medical College","correspondingAuthor":false,"prefix":"","firstName":"YongXiang","middleName":"","lastName":"Song","suffix":""},{"id":634122855,"identity":"acc6819c-a0f2-463b-a8cf-761d5243a000","order_by":3,"name":"KHAMMALA AKOUY","email":"","orcid":"","institution":"National University of Laos","correspondingAuthor":false,"prefix":"","firstName":"KHAMMALA","middleName":"","lastName":"AKOUY","suffix":""},{"id":634122878,"identity":"013b317d-db1b-424d-998c-4a3a011c25d4","order_by":4,"name":"Junliang Ma","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYLACiQobORB94AHRWizOpBmDtSQQraWy5XBiA4hBlBb56OZnD242MKfPDzv8EGiLnZxuAwEthneOmRvO3MGWu/F2mgFQS7Kx2QFCWmYkmElLnuHJ3Tg7AaTlQOI2wlrSv0n/bZNIN5yd/oE4LfISOWYSkm0GCfLSOUTaYiBzpkxC4kyC4QbpnIIDCQZE+EV+dvs2CYmK//Lys9M3f/hQYSdHUIvBDRgDrNKAgHKwLTNgjAYiVI+CUTAKRsHIBADvAEfq8y1QIgAAAABJRU5ErkJggg==","orcid":"","institution":"Affiliated Hospital of Zunyi Medical College","correspondingAuthor":true,"prefix":"","firstName":"Junliang","middleName":"","lastName":"Ma","suffix":""}],"badges":[],"createdAt":"2026-04-17 10:24:55","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9447825/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9447825/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108804900,"identity":"3623cb08-9b1f-4898-8a96-6e8e0a88400c","added_by":"auto","created_at":"2026-05-08 15:24:11","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":604594,"visible":true,"origin":"","legend":"","description":"","filename":"1.manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9447825/v1_covered_334371b3-482a-4698-88cb-4ef6647018f5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Information Quality of Short Videos on Esophageal Cancer Risk Factors on Douyin and TikTok: A Cross-Sectional Study of Social Media-Based Risk Communication With a Focus on Warnings About Hot Foods","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-digital-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Digital Health](https://bmcdigitalhealth.biomedcentral.com/)","snPcode":"44247","submissionUrl":"https://submission.nature.com/new-submission/44247/3","title":"BMC Digital Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"digital health, social media, Douyin, TikTok, esophageal cancer, health information quality, risk communication","lastPublishedDoi":"10.21203/rs.3.rs-9447825/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9447825/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eShort-video platforms are increasingly used for health information seeking and have become important channels for digital health communication. However, evidence on the quality of short videos addressing esophageal cancer risk factors remains limited, particularly across paired platform ecosystems such as Douyin and TikTok. Differences in creator composition, audience engagement, and the dissemination of culturally relevant warnings about very hot foods have not been adequately characterized.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo evaluate the information quality of short videos related to esophageal cancer risk factors on Douyin and TikTok, compare creator composition, user engagement, and dissemination of warnings about very hot foods across platforms, and identify factors associated with higher-quality content.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eOn March 15, 2026, searches were conducted on Douyin and TikTok using the keywords #食管癌, #食道癌, and esophageal cancer. Publicly accessible videos were consecutively collected according to each platform\u0026rsquo;s default ranking using newly registered accounts on separate devices with cleared caches and browsing histories. Extracted variables included video duration, number of followers, likes, comments, shares, content theme, creator type, presentation format, and whether the video mentioned warnings about very hot foods. Content themes were categorized as treatment, diagnosis, prevention, etiology, or other. Video quality was assessed using the modified DISCERN (mDISCERN) instrument and the Global Quality Scale (GQS). Two reviewers independently rated each video, and the mean score was used for the primary analysis. Interrater agreement was evaluated using weighted Cohen kappa. Statistical analyses included the Mann-Whitney U test, chi-square test, Spearman rank correlation, principal component analysis, and ordinal logistic regression.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 516 videos were included, comprising 279 from Douyin and 237 from TikTok. Interrater agreement was high (weighted kappa\u0026thinsp;=\u0026thinsp;0.969 for mDISCERN and 0.928 for GQS). Douyin videos were longer than TikTok videos [91 (66\u0026ndash;134) s vs 56 (19\u0026ndash;92) s, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001], whereas TikTok videos had higher median numbers of likes, comments, and shares (all P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Within the sampled results, Douyin videos scored higher than TikTok videos on both mDISCERN and GQS [mDISCERN: 3.0 (2.0\u0026ndash;4.0) vs 1.0 (1.0\u0026ndash;2.0); GQS: 4.0 (4.0\u0026ndash;4.0) vs 3.0 (3.0\u0026ndash;4.0); both P\u0026thinsp;\u0026lt;\u0026thinsp;0.001]. Douyin content was primarily posted by medical professionals and medical institutions (70.3% and 24.4%, respectively), whereas TikTok content was predominantly posted by lay individuals and science communication creators (54.4% and 24%, respectively). Warnings about very hot foods were substantially more common on Douyin than on TikTok [31.9% (89/279) vs 7.2% (17/237), P\u0026thinsp;\u0026lt;\u0026thinsp;0.001]. Video duration was positively correlated with both GQS and mDISCERN (rho\u0026thinsp;=\u0026thinsp;0.348 and rho\u0026thinsp;=\u0026thinsp;0.330, respectively; both P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Ordinal logistic regression showed that longer video duration was a stable positive correlate of higher quality ratings, whereas TikTok was significantly associated with lower quality categories.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIn this cross-sectional comparison of social-media-based esophageal cancer risk communication, Douyin videos had higher information-quality scores than TikTok videos within the sampled search results. Although TikTok videos showed greater user engagement, engagement metrics did not reliably reflect content quality. The observed differences appeared to be shaped jointly by creator composition, language environment, audience ecosystem, and platform governance. These findings support stronger expert participation, information transparency, and platform-level quality signals in digital health communication on short-video platforms.\u003c/p\u003e","manuscriptTitle":"Information Quality of Short Videos on Esophageal Cancer Risk Factors on Douyin and TikTok: A Cross-Sectional Study of Social Media-Based Risk Communication With a Focus on Warnings About Hot Foods","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-05 21:45:52","doi":"10.21203/rs.3.rs-9447825/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-04-27T08:47:05+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-25T08:39:37+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-23T15:50:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-23T15:49:27+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Digital Health","date":"2026-04-17T10:09:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-digital-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Digital Health](https://bmcdigitalhealth.biomedcentral.com/)","snPcode":"44247","submissionUrl":"https://submission.nature.com/new-submission/44247/3","title":"BMC Digital Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b962de79-aa05-4b11-b380-6856bc02c32c","owner":[],"postedDate":"May 5th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-05T21:45:52+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-05 21:45:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9447825","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9447825","identity":"rs-9447825","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}