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medRxiv

Adolescent engagement and sentiment toward reproductive-health videos on Chinese social media: a cross-sectional content analysis

Using an 18-keyword query, this study retrieved 743 Bilibili reproductive-health videos published between September 2016 and June 2024, covering 486.8 million views, 12.3 million likes, and roughly 760,000 textual entries, described engagement metrics with descriptive and Pearson-correlation analyses, and applied a three-class sentiment classifier powered by Qwen2.5-32B to comments and danmaku, finding that adolescent engagement centres on basic contraception while niche or contentious topics (sterilisation surgery 3.0%, fertility-awareness-based methods 2.3%) attract disproportionately high interaction, only 17% of uploaders had confirmed medical training, and negative sentiment predominated for induced abortion (52.2%) and novel contraceptives (52.