This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Diabetes, is properly cited. The complete bibliographic information, a link to the original publication on http://diabetes.jmir.org/, as well as this copyright and license information must be included.
An emergent source of information on health issues is the Internet. One such platform with 1 billion users is YouTube, the global video-sharing service.
The purpose of this study was to describe the content and characteristics of the most widely viewed YouTube videos related to diabetic retinopathy.
Videos were sorted according to number of views using the key words “diabetic retinopathy.” For each video, general descriptive information was collected. This information included date and source of upload (news, professional, or consumer), length, and total number of views as of July 18, 2016. Content categories were largely informed by a National Eye Institute fact sheet. Each video was viewed to determine which, if any, of the given content categories were present.
Of the 98 most widely viewed videos related to diabetic retinopathy, 42 were generated by consumers, 40 were generated by professionals, and 16 were generated from news-based sources. The largest number of views were generated from professionals (624,770/994,494, 63.82%). Compared with professional videos, consumer videos were viewed less frequently (
Future research is needed to identify aspects of YouTube videos that attract viewer attention and best practices for using this medium to increase diabetic retinopathy screening among people with diabetes.
Diabetic retinopathy is the leading cause of blindness in adults of working age in the United States [
People with diabetes are turning to the Internet for information. A study of young adults with diabetes indicated that they frequent websites uploaded by both professionals and consumers [
Videos were searched on YouTube.com using Chrome as a browser with a clean search history. The search term “diabetic retinopathy” was used for this study. Video popularity was established by filtering videos by total view count. The cut point of 100 most popular videos was set, and 2 of the videos were excluded because they were not in English. Thus, the final sample included 98 videos. The National Eye Institute (NEI) fact sheet entitled “Facts About Diabetic Eye Disease” was used as a guide in creating categories to code the content of the videos [
Consumer videos were defined as those uploaded by a user with no depicted professional affiliations. Professional videos were defined as those posted by a trained health professional. News clips included any news from a television network or Internet-based news station. One author (AB) coded the entire sample of 100 videos. To demonstrate interrater reliability, 10 videos were chosen using a random number generator and were then coded by both AB and CHB. For the 10 videos that were doubly coded, Cohen’s kappa was .8 and percentage agreement was 90% for one category (“Purpose of the video was to provide information about diabetic retinopathy”); for all other categories, there was 100% agreement.
Content categories were coded as “yes—mentioned” or “no—not mentioned” for each topic category. The categories used to code the videos were as follows: (1) gender of person providing information in the video (4 categories: no people shown, men shown, women shown, and both men and women shown), (2) purpose of the video was to provide information about diabetic retinopathy, (3) showed or mentioned diabetic retinopathy, (4) showed or mentioned proliferative diabetic retinopathy, (4) showed or mentioned nonproliferative diabetic retinopathy, (5) mentioned screening for diabetic retinopathy, (6) mentioned macular degeneration, (7) mentioned vision loss or blindness, (8) mentioned cataracts, (9) mentioned pain (if any) associated with diabetic retinopathy, (10) mentioned anxiety or fear of the diagnosis or screening, (11) mentioned control of diabetes, (12) mentioned symptoms (if any) for diabetic retinopathy, (13) mentioned treatment (if any) for diabetic retinopathy, (14) mentioned prevention (if any) for diabetic retinopathy, (15) mentioned that diabetic retinopathy can go unnoticed, and (16) mentioned retinal detachment.
Analysis was conducted using R version 3.3.0 (The R Foundation). Descriptive statistics were obtained using functions “summ” and “ci” from R package epiDisplay version 3.2.2.0 [
The institutional review boards at William Paterson University and Teachers College, Columbia University, do not review studies that do not involve human subjects.
Descriptive statistics for the videos are presented in
The frequency of diabetic retinopathy videos by content and source are displayed in
The odds ratio of categories of sources of YouTube videos as compared to consumer-generated videos for each content category is presented in
Length of videos and the number of views of 98 diabetic retinopathy–related videos in English.
Video length (in minutes) | Number of views | |||||||||
n | Mean (SE) | Median | Range | 95% CI | Mean (SE) | Median | Range | 95% CI | Total (%) | |
Consumer | 42 | 10.24 |
2.90 | 0.25-97.60 | 4.04-16.44 | 6104 |
3992 | 1728-68,540 | 2916-9292 | 256,373 |
News | 16 | 6.49 |
2.23 | 0.59-44.48 | 0.69-12.29 | 7084 |
6122 | 1848-17,760 | 4503-9666 | 113,351 |
Professional | 40 | 8.26 |
3.98 | 0.42-113.02 | 2.45-14.08 | 15,620 |
6194 | 1758-119,100 | 8698-22,540 | 624,770 |
Overall | 98 | 8.82 |
3.24 | 0.25-113 | 5.23-12.41 | 10,148 |
5169 | 1728-119,100 | 6933-13,363 | 994,494 |
Frequency count of 98 diabetic retinopathy–related videos in English by their sources and contents.
Source category of videos | |||||
Content category | Consumer |
News |
Professional |
Total |
|
No people featured | 18 (43) | 2 (13) | 6 (15) | 26 (27) | |
Man featured | 11 (26) | 8 (50) | 17 (43) | 36 (37) | |
Woman featured | 10 (24) | 3 (19) | 10 (25) | 23 (24) | |
Both featured | 3 (7) | 3 (19) | 7 (18) | 13 (13) | |
No | 21 (50) | 5 (31) | 13 (33) | 39 (40) | |
Yes | 21 (50) | 11 (69) | 27 (68) | 59 (60) | |
No | 11 (26) | 4 (25) | 8 (20) | 23 (24) | |
Yes | 31 (74) | 12 (75) | 32 (80) | 75 (77) | |
No | 29 (69) | 15 (94) | 28 (70) | 72 (74) | |
Yes | 13 (31) | 1 (6) | 12 (30) | 26 (27) | |
No | 34 (81) | 16 (100) | 31 (78) | 81 (83) | |
Yes | 8 (19) | 0 (0) | 9 (23) | 17 (17) | |
No | 27 (64) | 8 (50) | 23 (58) | 58 (59) | |
Yes | 15 (36) | 8 (50) | 17 (43) | 40 (41) | |
No | 40 (95) | 14 (88) | 36 (90) | 90 (92) | |
Yes | 2 (5) | 2 (13) | 4 (10) | 8 (8) | |
No | 21 (50) | 5 (31) | 16 (40) | 42 (43) | |
Yes | 21 (50) | 11 (69) | 24 (60) | 56 (57) | |
No | 39 (93) | 16 (100) | 37 (93) | 92 (94) | |
Yes | 3 (7) | 0 (0) | 3 (8) | 6 (6) | |
No | 39 (93) | 16 (100) | 39 (98) | 94 (96) | |
Yes | 3 (7) | 0 (0) | 1 (3) | 4 (4) | |
No | 40 (95) | 15 (94) | 38 (95) | 93 (95) | |
Yes | 2 (5) | 1 (6) | 2 (5) | 5 (5) | |
No | 25 (60) | 5 (31) | 17 (43) | 47 (48) | |
Yes | 17 (41) | 11 (69) | 23 (58) | 51 (52) | |
No | 24 (57) | 6 (38) | 20 (50) | 50 (51) | |
Yes | 18 (43) | 10 (63) | 20 (50) | 48 (49) | |
No | 17 (41) | 9 (56) | 16 (40) | 42 (43) | |
Yes | 25 (60) | 7 (44) | 24 (60) | 56 (57) | |
No | 30 (71) | 8 (50) | 27 (68) | 65 (66) | |
Yes | 12 (29) | 8 (50) | 13 (33) | 33 (33) | |
No | 39 (93) | 13 (81) | 28 (70) | 80 (82) | |
Yes | 3 (7) | 3 (19) | 12 (30) | 18 (18) | |
No | 36 (86) | 13 (81) | 29 (73) | 78 (80) | |
Yes | 6 (14) | 3 (19) | 11 (28) | 20 (20) |
The odds ratios of news and professional videos carrying contents pertinent to certain content compared with consumer-generated videos.
Content category | Odds ratio (95% CI) | ||
News: man featured | 6.55 (1.17-36.61) | .032 | |
News: woman featured | 2.70 (0.38-18.96) | .318 | |
News: both featured | 9.00 (1.03-78.57) | .047 | |
Professional: man featured | 4.64 (1.40-15.32) | .012 | |
Professional: woman featured | 3.00 (0.84-10.72) | .091 | |
Professional: both featured | 7.00 (1.36-36.01) | .020 | |
News | 2.20 (0.65-7.44) | .205 | |
Professional | 2.08 (0.85-5.09) | .110 | |
News | 1.06 (0.28-4.00) | .926 | |
Professional | 1.42 (0.50-4.00) | .508 | |
News | 0.15 (0.02-1.25) | .079 | |
Professional | 0.96 (0.37-2.45) | .925 | |
Newsa | — | — | |
Professional | 1.23 (0.42-3.60) | .700 | |
News | 1.80 (0.56-5.77) | .323 | |
Professional | 1.33 (0.55-3.24) | .529 | |
News | 2.86 (0.37-22.24) | .316 | |
Professional | 2.22 (0.38-12.87) | .373 | |
News | 2.20 (0.65-7.44) | .205 | |
Professional | 1.50 (0.63-3.60) | .364 | |
Newsa | — | — | |
Professional | 1.05 (0.20-5.56) | .951 | |
Newsa | — | — | |
Professional | 0.33 (0.03-3.35) | .350 | |
News | 1.33 (0.11-15.81) | .82 | |
Professional | 1.05 (0.14-7.85) | .96 | |
News | 3.24 (0.95-11.00) | .060 | |
Professional | 1.99 (0.83-4.79) | .125 | |
News | 2.22 (0.68-7.25) | .186 | |
Professional | 1.33 (0.56-3.18) | .517 | |
News | 0.53 (0.17-1.69) | .284 | |
Professional | 1.02 (0.42-2.47) | .965 | |
News | 2.50 (0.76-8.19) | .130 | |
Professional | 1.20 (0.47-3.09) | .699 | |
News | 3.00 (0.54-16.74) | .210 | |
Professional | 5.57 (1.44-21.60) | .013 | |
News | 1.38 (0.30-6.36) | .676 | |
Professional | 2.28 (0.75-6.90) | .146 |
aIf all videos belong to a particular category of source of video, then we cannot calculate the odds ratio and the standard error will not be meaningful.
To our knowledge, this is the first study to describe the content of YouTube videos related to diabetic retinopathy. The importance of this eye disease is highlighted by the personal consequences for individuals affected [
With pervasive use of mobile technology, efforts using innovative communication methods are emerging. Systematic reviews of mHealth interventions for facilitating self-management of long-term illness [
This study was limited by the cross-sectional design, the inability to delineate the country of origin of each video, and the fact that it was limited to those videos with contents in English. In addition, the sample size was relatively small and the cut-off point of 100 videos was arbitrary. Despite these limitations, this study begins to fill a gap in the literature related to diabetic retinopathy and YouTube.
Future research is needed to identify aspects of YouTube videos that attract viewer attention and best practices for using this medium for increasing diabetic retinopathy screening among people with diabetes.
Centers for Disease Control and Prevention
National Eye Institute
No financial support was received for this project. ICHF received salary support from the Centers for Disease Control and Prevention (CDC) (16IPA1609578); however, this paper is not related to his CDC projects, and the CDC has no role at all in this project. The opinions expressed in this paper do not represent the official position of the CDC or the United States government.
None declared.