Dear Editor:

Social media platforms are increasingly used to disseminate health promotion and patient education.1–5 Impressions click-through rate (CTR) is the number of clicks on a health promotion and/or patient education ad, divided by the times the ad was shown on a social media platform. A recent study explored the practicality of Facebook advertising to a targeted Chinese population and found the CTR to be 10.2 percent for a hypertension education campaign.1 Another observational, cross-sectional study found the CTR for a Facebook advertisement on an education video for falls in the elderly to be 11.1 percent.2 However, a recent study using a Facebook advertisement failed to generate a CTR for a health promotion campaign on early psychosis.3 Previous studies have reported that YouTube as a social media platform could be useful in disseminating dementia health knowledge to the Chinese-speaking general public.6–10 Here, we report the impressions CTR of YouTube dementia videos in targeting the Chinese-speaking general public who are in the high-risk age group (e.g., aged 65 years and above) of developing dementia. Institutional review board approval was not necessary because data contained no information that could be linked to specific individuals.

Methods. A board-certified psychiatrist was invited by a Chinese television station for two educational talk shows in Cantonese, which covered topics centered on dementia background, management, and prevention. The real-time recording was then uploaded to YouTube as two 25-minute videos. The sample of this study included viewers who have watched the videos in the year of 2018. Using YouTube Analytics, the recorded parameters included age, sex, device type, watch time (minutes), number of views, average view duration, traffic source, impressions, and impressions CTR.

Results. In 2018, the YouTube videos recorded a total watch time of 75,397 minutes from 9,684 viewers aged 65 years or older. Male and female viewers accounted for 5,074 (52.4%) and 4,610 (47.6%) views, respectively. These elderly viewers watched an average view duration of 7.5 minutes. Most viewers watched the contents using wireless devices, such as mobile phones (62.8%, n=6,083) and tablets (18.6%, n=1,805). The two videos generated a CTR of 7.0 percent (n=5,928) from a total of 84,688 impressions.

Suggested videos as a traffic source recorded 5,713 views, a total watch time of 47,110 minutes, and a CTR of 9.3 percent (n=4,092) from a total of 43,996 impressions. These viewers had an average view duration of 8.3 minutes, which was 10.7-percent longer than the overall average view duration of 7.5 minutes.

Discussion. To our knowledge, there are no reports on impressions CTR of YouTube as a social media platform for dementia education videos. YouTube as an e-mental health platform was able to outreach to viewers who are in the high risk age group of developing dementia. The CTR provided a way to measure not only awareness of these dementia education contents on a social media platform, but also whether these elderly viewers expressed further interest in dementia education by clicking on these videos. Furthermore, suggested videos as a traffic source recorded a higher CTR and a longer average view duration, indicating that YouTube as a social media platform was able to target Chinese-speaking general public interested in additional dementia education. However, the CTR from suggested videos as a traffic source was approximately 1 to 2 percent less than impressions click-through rates generated by studies using paid Facebook advertising.1,2 These results suggest that future studies should examine ways to improve CTR for health promotion and patient education on social media platforms.

Limitations. Due to the method of data collection, however, a limitation to the study was the relative lack of demographic data from individual viewers who were not logged into their accounts. Future studies should prospectively study how elderly viewers use YouTube as an e-mental health platform to further understand their viewing patterns.

Conclusion. By leveraging YouTube, health professionals can effectively outreach and disseminate timely, evidence-based health information to the general public.


  1. Dunn PH, Woo BK. Facebook recruitment of Chinese-speaking participants for hypertension education. J Am Soc Hypertens. 2018;12:690–692.
  2. Lam NH, Woo BK. Digital media recruitment for fall prevention among older Chinese-American individuals: observational, cross-sectional study. JMIR Aging. 2018;1:e11772.
  3. Woo BK. Facebook advertising for disseminating early psychosis education to the Chinese-speaking general public. Health Equity. 2019;3:19–21.
  4. Dunn PH, Woo BK. Facebook advertising for disseminating hypertension knowledge to older Chinese adults. J Hypertens. 2018;36:962.
  5. Cheng T, Liu L, Woo BK. Analyzing Twitter as a platform for Alzheimer-related dementia awareness: thematic analyses of tweets. JMIR Aging. 2018;1:e11542.
  6. Woo BK. Dementia health promotion for Chinese Americans. Cureus. 2017;9:e1411.
  7. Lam NH, Tsiang JT, Woo BK. Exploring the role of youtube in disseminating psychoeducation. Acad Psychiatry. 2017;41:819–822.
  8. Zheng X, Woo BK. E-mental health in ethnic minority: a comparison of YouTube and talk-based educational workshops in dementia. Asian J Psychiatry. 2017;25:246–248.
  9. Lam NH, Woo BK. Exploring the role of YouTube in delivering dementia education to older Chinese. Asian J Psychiatry. 2018;31:25–26.
  10. Woo BK. An evaluation of youtube in disseminating dementia knowledge to older Chinese in Britain. Int Psychogeriatr. 2018;30:1575.

With regards,

Benjamin K.P. Woo, MD

Asian Pacific Health Corps, University of California, Los Angeles, California

Funding/financial disclosures. The author has no conflict of interest relevant to the content of this letter. No funding was received for the preparation of this letter.