Bilibili/TikTok Videos as Sources of HPV-Related Medical Information: A Cross-Sectional Content Analysis

Background Bilibili and TikTok are prominent platforms for long-form and short-form videos, respectively, hosting a large number of Human Papillomavirus (HPV)-related videos. This study aims to identify the upload sources, content, and characteristic information of these HPV-related videos on Bilibili and TikTok, further evaluate their quality, and ultimately provide a reference basis for the public to access reliable HPV information and for platforms to optimize their content ecosystems. Methods This study adopted a similar content analysis process. On August 8, 2025 (one week after the national HPV vaccine promotion campaign to avoid seasonal traffic bias), three sets of search terms—'HPV vaccine', 'human papillomavirus infection', and 'cervical cancer screening'—were used to retrieve videos on Bilibili and TikTok. The top 100 videos from each platform were selected based on the default 'comprehensive ranking' (integrating views, engagement, and timeliness). During the sample screening phase, the following contents were excluded: ① videos published less than 7 days ago (with unstable engagement data); ② videos with platform advertising labels or promoting HPV - related products; ③ irrelevant content that only occasionally mentions HPV (such as celebrity news); ④ duplicate reprinted videos with the same title, content, and upload time. The recorded dimensions of video characteristics included title, URL, upload time, duration, and engagement indicators (number of likes, comments, favorites, and reposts). Three tools were used for quality assessment: a customized HPV Quality Assessment Checklist, the Global Quality Score (GQS), and the Patient Education Materials Assessment Tool (PEMAT)[1]. The methodological design of this study referred to the social media health video content analysis framework proposed by Liu et al. (2024), with details available in[1]. Results We analyzed 99 TikTok videos and 98 Bilibili videos (after removing duplicates and irrelevant content). Video Duration and Interaction: TikTok has short videos with strong audience interaction; Bilibili has long videos. Uploader Types and Video Categories: TikTok has more medical scenario-based videos (aided by platform policies). Bilibili has diverse content, with more non-professional PPT/lecture - style videos. Video Quality Assessment: Except for GQS, the two platforms had significant differences in 11 indicators (PEMAT scores, completeness scores, etc.). Bilibili had higher quality in 11 indicators, with no difference between professional and non-professional uploaders. Correlation Analysis: For TikTok, video duration showed a significant positive correlation with quality scores: PEMAT-T (r=0.22, p<0.05) and GQS (r=0.46, p<0.01). However, interaction metrics (likes, comments, favorites, reposts) exhibited weak or non-significant correlations with quality scores: the correlation coefficient between likes and PEMAT-T was r=-0.01 (p>0.05), between comments and PEMAT-T was r=-0.02 (p>0.05), between favorites and PEMAT-T was r=0.04 (p>0.05), and between reposts and PEMAT-T was r=-0.07 (p>0.05). For Bilibili, likes (r=0.25, p<0.05), comments (r=0.20, p<0.05), favorites (r=0.29, p<0.01), and reposts (r=0.31, p<0.01) all demonstrated significant positive correlations with the total quality score. Additionally, video duration was significantly positively correlated with GQS (r=0.31, p<0.01) and total quality score (r=0.50, p<0.01). Nevertheless, PEMAT-T showed weak or non-significant correlations with interaction metrics: r=-0.05 (likes, p>0.05), r=-0.12 (comments, p>0.05), r=-0.04 (favorites, p>0.05), and r=-0.05 (reposts, p>0.05)n. Conclusion HPV-related videos on social media platforms can help the public understand HPV knowledge to a certain extent. Specifically, among the HPV - related video samples selected in this study, TikTok achieved better traffic dissemination due to its platform characteristics of short duration and high engagement (e.g., median number of likes: 6011 vs. 420.5 for Bilibili, p < 0.01), while HPV videos on Bilibili performed better in 11 quality indicators (including PEMAT - T and completeness score) (p < 0.01). However, it should be noted that there is room for improvement in the quality of HPV videos on both platforms: the median score of TikTok in the 'HPV Prevention Measures' dimension was only 0 (P25 = 0.00, P75 = 1.00), and 32% of videos uploaded by non - professional uploaders on Bilibili (accounting for 40.82%) failed to clearly explain the 'association between HPV types 16/18 and cervical cancer. Based on this, this study proposes 3 specific recommendations tailored to HPV prevention and control needs: ① Platform level: TikTok can set a 'quality access threshold' for high-frequency search tags such as 'HPV vaccine' and 'cervical cancer screening' (e.g., PEMAT-A ≥ 0.8 for recommendation), giving priority to pushing actionable content including 'vaccination procedures' and 'screening intervals'; ② Creator level: Professionals are encouraged to create in-depth content such as 'interpretation of HPV genotyping test results' and 'management of persistent infection' (37.5% of professional videos on Bilibili cover this topic, while only 8.3% on TikTok), filling the gap of in-depth information on short video platforms; ③ Regulatory level: It is recommended to include 'HPV information quality' in the public health assessment indicators of social media, and regularly release quality reports of various platforms to guide the public to choose reliable information. However, the effectiveness of this strategy needs to be verified by more platforms and larger - sample HPV video data, and it cannot be extended to all medical videos for the time being.