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What are patients watching? A quality and content evaluation of YouTube videos about gestational diabetes. (Preprint)


 BACKGROUND
 People with gestational diabetes mellitus have enhanced learning requirements during pregnancy, and management of their disease often requires the translation of health information into new health behavior changes. Seeking online information to augment learning from health professionals is becoming more common during pregnancy. YouTube is a popular, free, and accessible online resource, which may be particularly useful for individuals with low health literacy or other barriers to receiving high-quality health care. However, the quality and content of YouTube videos varies, and little is known about those covering gestational diabetes.
 
 
 OBJECTIVE
 The objective was to systematically evaluate the quality, content, and reliability of YouTube videos about gestational diabetes.
 
 
 METHODS
 A systematic search of YouTube videos was conducted using four gestational diabetes-related keywords. The search display of “relevance” was used to collect videos, replicating a default YouTube search attempt. The first 60 results (three pages of results) from each keyword search were reviewed (N=240) and each unique video was analyzed using the following standardized criteria. An expert-developed topic list was used to generate a gestational diabetes content score to rate video comprehensiveness and accuracy, and the DISCERN Instrument, a validated metric to assess consumer health information, was used to evaluate the reliability of information presented. Videos were further categorized by quality: all videos with DISCERN scores lower than three or covering fewer than four topics out of seven on the content score were categorized as “low quality,” and all others were designated “high quality.” Descriptive analysis and intergroup comparisons by video source and quality were conducted.
 
 
 RESULTS
 Of 115 unique videos, the average content score was 3.5 out of 7 (standard deviation 2.0), and the average DISCERN score was 2.7 out of 5 (standard deviation 0.7), representing low to moderate information comprehensiveness and reliability respectively. Video sources were categorized as personal vlog (10.4%), online education (32.2%), medical (45.2%), business/company (10.4%), and media clip (<1%). DISCERN and content scores trended higher among medical and online education videos. The majority of videos (n = 88) were categorized as low quality, while 27 videos were categorized as high quality. Video duration was longer for high-quality videos (P<.001); high- and low-quality videos otherwise had similar views and viewer interaction numbers.
 
 
 CONCLUSIONS
 Although high-quality videos about gestational diabetes mellitus exist, reliability, accuracy, and comprehensiveness were overall low, and higher quality was not associated with increased viewer interaction. Given that patients may seek information from YouTube with or without provider input, it is important to acknowledge the limitations of this platform and assist patients both in accessing high quality content and in differentiating the quality of information sources.
