Quality Assessment of and User Engagement With Short Videos About Breast Cancer Screening on Douyin, Kuaishou, and TikTok: Cross-Sectional Content Analysis Study

Background Breast cancer screening plays a critical role in early detection and mortality reduction. Short video platforms have become widely used channels for patient education, but the quality and reliability of breast cancer screening information on short video platforms remain unclear. Objective This study aimed to explore and compare the source, content characteristics, and quality of short videos on breast cancer screening across 2 major Chinese-language platforms (Douyin and Kuaishou) and the English-language platform TikTok. Methods Using the keyword “breast cancer screening,” this study retrieved and screened the top 100 short videos from each of the 3 platforms—Douyin, Kuaishou, and TikTok—resulting in a final sample of 258 eligible videos. Basic video information, user engagement metrics, and uploader characteristics were collected. A total of 3 breast disease specialists independently evaluated the content using 4 tools: the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), modified DISCERN (mDISCERN), Global Quality Score (GQS), and Journal of the American Medical Association benchmark criteria (JAMA-BC), which assess understandability and actionability, overall quality, educational value, and reliability, respectively. Statistical analyses included Kruskal-Wallis tests, Dunn-Bonferroni tests, chi-square tests, and Spearman correlation analysis. Results Videos on TikTok had significantly lower scores on the mDISCERN, GQS, and JAMA-BC than those on Douyin and Kuaishou, indicating poorer overall quality and reliability. The median mDISCERN scores were 1.50 (IQR 1.00-2.00) for TikTok compared to 3.00 (IQR 2.00-3.00) for both Douyin and Kuaishou (P<.001), the median GQS scores were 2.00 (IQR 2.00-3.00) for TikTok compared to 3.00 (IQR 2.50-4.00) (P<.001) for Douyin and 3.00 (IQR 3.00-3.50) (P<.001) for Kuaishou, and the median JAMA-BC scores were 10.00 (IQR 8.25-12.00) for TikTok compared to 12.00 (IQR 10.00-12.00) (P<.001) for Douyin and 12.00 (IQR 10.00-14.00) (P<.001) for Kuaishou. The PEMAT-A scores of Douyin and Kuaishou were also significantly lower on TikTok (Douyin vs TikTok: P=.002; Kuaishou vs TikTok: P=.02). Health care professionals were the main content creators on Douyin (49/66, 74.2%) and Kuaishou (56/69, 81.1%), while individual content creators dominated TikTok (33/72, 45.8%). Authentication rates were significantly lower on TikTok (9/72, 12.5%) than on Kuaishou (35/69, 50.7%) and Douyin (58/66, 87.9%). Viewer engagement metrics, including likes, comments, and collections, were nonsignificant or negatively correlated with video quality. For example, mDISCERN scores were negatively correlated with the number of likes per 30 days (P<.001). Conclusions This study reveals that high-quality videos on breast cancer screening tend to attract lower viewer engagement, highlighting platform-specific disparities and challenges in dissemination. It is recommended that short video platforms implement stricter review processes for health-related videos and uploaders. Additionally, governmental or related agencies should provide media training for health care professionals in public science communication to enhance the impact and effectiveness of health education via short videos.