Quality and dissemination of hand, foot, and mouth disease–related videos across six social media platforms: a cross-sectional study

Hand, foot, and mouth disease (HFMD) predominantly affects young children, making parents and caregivers key users of online health information. This study evaluated the quality, transparency, and dissemination characteristics of HFMD-related videos across six social media platforms. In this cross-sectional content analysis, 600 videos were sampled from Bilibili, Xiaohongshu, Douyin, Kuaishou, WeChat Channels, and YouTube between May 20 and June 5, 2026. Video quality was assessed using the Global Quality Score (GQS), Journal of the American Medical Association (JAMA) benchmark criteria, and modified DISCERN instrument. A 20% random subsample was independently rated by two reviewers. Multivariable linear regression with HC3 robust standard errors examined associations with composite quality, and Spearman analyses assessed relationships with dissemination metrics. The median composite quality score was 8.0 (IQR, 5.0–9.0). Inter-rater reliability was good to excellent (ICC, 0.802–0.884). After adjustment, physician-, hospital-, and news organization–published videos scored 3.460, 5.476, and 2.055 points higher, respectively, than independent-user videos (all P < 0.001). Most platform differences were markedly attenuated after accounting for publisher source and other video characteristics. Findings remained consistent when GQS and modified DISCERN were analyzed separately and when JAMA was excluded. Likes, comments, saves, and shares were not associated with composite quality, and follower count was not independently associated after full adjustment. Apparent platform differences in HFMD video quality were driven largely by creator composition rather than platform identity. Professional and institutional sources provided higher-quality information, whereas visible engagement metrics were unreliable indicators of quality.