How effective are video animations as information tools for patients and the general public? An updated systematic review

Abstract

Background: Online and digital communications have changed information access, with many people using the internet for health information. Our 2022 systematic review showed that video animations can improve short-term patient and public knowledge but questions remained about their longer-term effectiveness, particularly for non-native speakers and those with low health literacy, and about their effects on attitudes, cognitions (e.g., self-perceptions) and behaviour. Methods: This review updates a previous systematic review on the effectiveness of video animations compared to other information formats. It includes randomised or quasi-randomised controlled trials, focusing on patients’ or public understanding of health topics. The same eligibility criteria and search strategy were used, without language restrictions, and multiple databases were reviewed to April 2025 (our 2022 review had searched from database inception to June 2021). Inclusion assessment, data extraction, and quality appraisal were conducted independently by two researchers. Findings are presented through narrative synthesis and albatross plots. Results: We included 87 publications (88 trials), including 50 trials new to this update, focusing on medical procedures (n = 40), condition management (n = 24) and public health (n = 24). The median trial sample size was 120 and trials had been undertaken in 28 different countries. Animations showed positive effects for knowledge [48/60 trials (80%)], attitudes and cognitions [28/53 trials (53%)] and behaviours [20/32 trials (63%)]Null effects were found in 18% studies assessing knowledge, 47% studies of attitudes and cognitions, and 34% studies of behaviour, with one negative effect each in knowledge (2%) and behaviour (3%). Overall, risk of bias was “high” (n = 37), “some concerns” (n = 35), or “low” (n = 16), often due to concerns about randomisation, blinding, small samples, missing data or unpublished protocols. Discussion: Video animations improve patient knowledge and behaviour in the short-term, with some positive effects on attitudes and cognitions. However, higher quality and larger randomised controlled trials are needed to evaluate longer-term outcomes, especially for individuals with low health literacy. Practitioners should consider incorporating animations into public health, health education and healthcare delivery while being mindful of current research limitations. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024559912, PROSPERO CRD42024559912.