High pedagogical quality does not ensure evidence-based grounding in videos disseminated on social media by health professionals.

Abstract

Social media platforms have become influential environments for health education, patient counseling, and health communication. Short-form videos produced by health professionals are widely consumed and perceived as credible, yet whether their pedagogical quality coincides with evidence-based grounding remains unclear. This study evaluated the pedagogical quality and evidence-based grounding of short-form health education content produced by health professionals on social media and determined the extent to which these two dimensions are associated across professional groups. This cross-sectional study analyzed 2000 videos from 100 health professionals (digital health influencers) in nursing, pharmacy, medicine, nutrition, and dentistry on TikTok and Instagram in Brazil, selected by a composite engagement rate. Pedagogical quality was assessed with the ECVIH, an educational-content instrument (18 items, 0-36), and evidence-based grounding with a six-dimension content-analysis coding framework (0-12) derived from established health-information quality criteria. Both were scored as continuous measures by trained reviewers with consensus adjudication and inter-rater reliability testing. Pedagogical scores were uniformly high (profession means 28.2-32.0), whereas evidence-based grounding was lower and more variable (means 7.2-9.3). Pedagogical quality explained only 24.0% of the variance in evidence-based grounding (r = 0.490; 31.8% with profession added), indicating that pedagogical quality is an unreliable predictor despite a positive, moderate correlation. The criterion capturing evidence limitations and uncertainties was among the weakest items, with zero-score rates of 44.64% in nutrition and 36.75% in medicine; even among the most pedagogically polished videos (highest ECVIH quartile), 18.8% provided no such caveats. Short-form health content is pedagogically strong, but its educational polish does not reliably predict evidence-based grounding. Polished delivery may obscure evidentiary gaps, fuel health misinformation, and increase patient informational vulnerability. Professional training and regulatory approaches in digital health education should explicitly incorporate competencies for evidence-based scientific translation.