Too Much of a Good Thing: Dramatic Strategies, Engagement and Knowledge Acquisition in Health-Related Short Videos

Dramatization is widely used in health-related short videos to enhance engagement and health outcomes. However, its educational value remains underexplored in health communication. This study combined content analysis and experimental design to examine how dramatic signs and dramatic structure influence engagement (likes, comments, shares, and favorites) and knowledge acquisition. Study 1 analyzed 841 health-related Douyin videos to assess the prevalence and effects of five dramatic signs (scene, auditory, visual, actor, and act) and dramatic structure. Results showed that visual and actor signs significantly increased engagement. However, their interaction revealed diminishing returns. Dramatic structure independently enhanced several engagement outcomes. Study 2 employed a 2 × 2 × 2 between-subjects experimental design to examine engagement intentions and knowledge acquisition. Consistent with Study 1, visual and actor signs increased engagement intentions with diminishing returns. No main effects emerged for knowledge acquisition. However, actor×structure interaction revealed a crossover effect: actor sign enhanced learning when structure was absent but impaired learning when structure was complete. Regression analysis showed that commenting intention negatively predicted knowledge acquisition, an effect that intensified as sharing intention increased. Conversely, sharing intention positively predicted knowledge only when other engagement intentions were low. These findings indicate that dramatization enhances engagement but yields conditional and sometimes counterproductive effects on learning.