Quality vs. Reach in Health Short Videos: A Dual-Path Test of the Heuristic–Systematic Model
Abstract
Short-video platforms such as Douyin broaden access to health information but may reward visibility over verifiability. Guided by the heuristic–systematic model, this study asks whether the same content features that improve information quality also help videos reach larger audiences. We retrieved 300 diabetes-related videos from Douyin’s “For You” feed in three logged-out collection waves, and after removing ineligible and duplicate cases, analyzed 276 videos. Using a mDISCERN-based coding scheme,we assessed systematic content cues (e.g., whether videos provided evidence-based, balanced information and concrete self-management guidance) and heuristic account and production cues (e.g., provider type, on-screen text, graphics, and background music). We then modeled two outcomes: a quality index and a dissemination index based on likes, comments, and shares. Multiple regression with robust standard errors showed that systematic cues were strongly and positively associated with higher information quality, whereas heuristic cues had a smaller, marginally significant association. By contrast, neither systematic nor heuristic cues significantly predicted dissemination. Cross-equation tests indicated that the effects of both cue types differed significantly between the quality and dissemination models, pointing to a credibility–visibility gap: features that make diabetes videos more accurate and transparent do not automatically increase their early reach on Douyin.
Keywords: short video, health communication, mDISCERN, dissemination, HSM.
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