Discrepancy between quality and engagement in digital neonatal health education: a cross-sectional evaluation of youtube videos on bronchopulmonary dysplasia

Abstract

Bronchopulmonary dysplasia (BPD) remains a significant source of morbidity among preterm infants, necessitating ongoing caregiver education. With YouTube becoming an increasingly popular platform for health-related content, this study aimed to evaluate the educational quality, reliability, and engagement performance of videos related to neonatal BPD. Methods: The authors conducted a cross-sectional review of the top 200 most-viewed English-language YouTube videos retrieved on February 16, 2025, using the term "bronchopulmonary dysplasia in newborns."After applying predefined exclusion criteria, 118 videos were evaluated independently by 2 neonatologists using 3 validated instruments: the Journal of the American Medical Association (JAMA) benchmarks, the Global Quality Scale (GQS), and the modified DISCERN tool. Viewer interaction was measured using the Video Engagement Index (VEI), and videos were classified by uploader type. Results: Among the included videos, 73.7% were uploaded by health care professionals. These videos exhibited significantly higher scores across all quality metrics (JAMA, GQS, and modified DISCERN) compared with those uploaded by independent users (P < 0.001). Conversely, independently uploaded videos demonstrated higher engagement (median VEI: 43.1 versus 21.6, P = 0.011). A strong positive correlation was found between GQS and DISCERN scores (ρ = 0.81), and inter-rater reliability was excellent across all tools (ICC > 0.90). Conclusion: Despite higher educational value, professional health care videos on neonatal BPD received less user engagement than those of lower quality. As one of the first studies specifically evaluating YouTube content on neonatal bronchopulmonary dysplasia, this discrepancy highlights the need for improved visibility of evidence-based medical content on open-access platforms and underscores the importance of integrating media literacy into caregiver education to ensure an accurate understanding of neonatal conditions. Copyright © 2025 by Mutaz B. Habal, MD.