Three-dimensional evaluation and optimization of breast cancer rehabilitation science popularization videos on mainstream video platforms: a cross-sectional study in Mainland China

Background With the growing number of breast cancer survivors, rehabilitation has become a critical component of comprehensive cancer care. Mainstream video platforms have emerged as a primary channel for patients to access rehabilitation information, yet the quality of such content remains unevaluated. This study aimed to systematically assess the quality and dissemination characteristics of breast cancer rehabilitation-related videos on TikTok, MicroBlog, and Today’s Headline. Method A cross-sectional design was employed. From June to July 2026, videos related to breast cancer rehabilitation were retrieved on three platforms using an account-free search mode. 450 valid samples (150 per platform) were selected and a three-dimensional evaluation system was established: content scientificity (modified DISCERN scale), dissemination presentation (Global Quality Scale), and source credibility (JAMA scale). Overall quality was the arithmetic mean of the three dimensions. Six evaluators conducted scoring; inter-rater reliability was tested by ICC(2,k). Post hoc power analysis confirmed sufficient power (>0.99) for detecting medium-effect differences. Result The overall quality score was 2.74 ± 0.85, with a pass rate (≥3.5) of only 19.8%; a sensitivity analysis using alternative cutoffs (≥3.0 and ≥4.0) yielded pass rates of 42.4% and 6.7%, respectively, confirming the robustness of the low-quality conclusion. TikTok's overall quality, content scientificity, and source credibility scores were significantly higher than MicroBlog and Today's Headlines (all P < 0.05, η 2 = 0.11–0.16), a difference partly attributable to TikTok's higher proportion of certified physicians. One-way ANOVA revealed significant overall differences among four creator types (F = 128.6, P < 0.001, η 2 = 0.46), with Tukey post hoc tests confirming certified physicians > rehabilitation nurses > health institutions > ordinary users. Subgroup analysis showed that sexual/reproductive rehabilitation videos had the lowest quality (2.45 ± 0.91). A weak negative association was observed between the engagement composite and quality (r = −0.18, 95% CI: −0.27 to −0.09, P < 0.001). Conclusion The overall quality of breast cancer rehabilitation popular science videos on Chinese mainstream platforms was low. Patients should prioritize content from certified physicians and health institutions that cite guidelines and present balanced information. Platform-specific regulation and greater participation by certified oncologists and rehabilitation specialists are urgently needed. Level of evidence Level II; Cross-Sectional Study