1 Introduction

Traditional Chinese medicine (TCM), rooted in thousands of years of Chinese history, not only possesses a unique theoretical framework and therapeutic practices, but also embodies rich cultural symbols and profound philosophical wisdom. As a vital embodiment of traditional Chinese culture and an integral part of global civilization (Wang and Xie, 2023, p.1), TCM has long carried significance beyond the medical realm, serving as an important vehicle for cultural exchange and cross-cultural understanding. However, the majority of international audiences know little about it, and many are influenced by stereotypes that label TCM as unscientific and as lacking empirical evidence, which hinders its cross-cultural dissemination to some extent (Chen et al., 2019, p.11). Therefore, clarifying international audiences’ understanding of and attitudes toward TCM is a key prerequisite for promoting its global dissemination. Only by gaining a deeper understanding of their emotional responses and cognitive concerns can we tailor communication strategies to be more targeted and effective.

The existing studies on the international dissemination of TCM can be roughly divided into three major areas. First, there is research on dissemination pathways (Periferakis and Periferakis, 2020; Yuan, 2021; Zhang et al., 2025); second, scholars examine the difficulties and challenges of TCM dissemination in the world (Chang et al., 2020; Liu, 2021; Wang, 2021); third, studies explore international reception and localization research of TCM (Candelise, 2011; Peng and Zhang, 2021; Yin, 2017; Wang and Wang, 2023). Overall, these studies collectively provide an overview of the historical and contemporary trajectory of the dissemination of TCM, identify the constraints and obstacles encountered in the dissemination process, and explain the acceptance of TCM in different regions and social groups.

However, the existing research still presents several limitations. First, the analyses of communication methods and challenges are much more common than systematic studies of audience reception and response. Yet audience reception ultimately determines the actual effectiveness of dissemination (Bao, 2015, p.13). Second, the existing research on audience reception primarily relies on questionnaires and interviews (Candelise, 2011; Peng and Zhang, 2021), or examines the translation and acceptance of TCM’s canons (Yin, 2017; Wang and Wang, 2023). However, these methods have methodological and empirical limitations. Surveys and interviews are particularly vulnerable to researcher bias and social desirability bias, which may obscure audiences’ spontaneous perceptions. At the same time, the interpretive responses to classical canons of TCM, which usually come from academic readers with high cultural capital, cannot fully represent the views of the general international public.

These limitations highlight the absence of systematic, large-scale analyses of the spontaneous responses of general international audiences. To address this gap, the present study analyzes four TCM documentaries on YouTube, integrating TCM communication research with digital reception studies. We first compare the relative popularity of the documentaries to identify content features that resonate with international audiences. “Reviews provide important clues for understanding the emotional dimensions and interpretive perspectives” (Zhou and Wang, 2025, p.60). We then apply natural language processing (NLP) techniques, including sentiment analysis and topic modeling, to examine English-language reviews from general audiences, extracting their emotional responses and major thematic concerns. Through this data-driven framework, the study aims to provide a more objective and comprehensive understanding of international audiences’ reception of TCM, as well as their affective orientations and primary areas of interest.

As the world’s largest video-sharing platform, YouTube “supports a high volume of visitors and a range of different audiences, offering participants a way to garner wide exposure” (Burgess and Green, 2018, p.4). Therefore, it is not only a key channel for content dissemination but also a dynamic space for the expression and exchange of audiences’ views. This makes it an ideal platform for obtaining sources that can be used to analyze the spontaneous perceptions, cognitive frameworks and value orientations of international audiences.

Against this background, TCM documentaries on YouTube play a dual role. They are not only an important medium for the international dissemination of TCM but also offer a key perspective for observing the international reception of TCM culture. The findings of this study provide new empirical data on the influence of TCM among general international audiences and offer practical insights for enhancing documentary production and optimizing global dissemination strategies of TCM.

2 Research Objects and Questions

This section provides an outline for the basic design of the research, including its objects and questions.  

2.1 Research Objects

This study analyzes four representative TCM documentaries on YouTube, which were selected on the basis of their different geographical backgrounds and narrative approaches (see Table 1). The first one, Qi - The Art of Traditional Chinese Medicine, explores the history and social practice of TCM through the concept of “Qi”, incorporating both cultural reflection and a critique of modern medical commercialization. The second one, The Tale of Chinese Medicine S1, adopts a humanistic perspective to trace the work and experiences of TCM masters across different regions in China, focusing on the interaction between practitioners and regional cultures. The third one, Journey to the West, addresses common Western misconceptions by presenting TCM as a coherent medical system seeking wider recognition within modern healthcare. And the last one, The Science Behind Traditional Chinese Medicine, employs the scientific communication framework to examine the historical application of traditional Chinese medicine plants from the perspective of modern pharmacology, emphasizing its potential significance for contemporary drug research and development.

TABLE 1  OVERVIEW OF SELECTED TCM DOCUMENTARIES

2.2 Research Questions

To systematically analyze the dissemination and reception of traditional Chinese medicine documentaries, this study aims to answer the following research questions:

RQ1: What differences exist in the popularity and dissemination performance of the four TCM documentaries on YouTube, and what factors explain these differences?

RQ2: What general emotions did the international audiences express about TCM in the comments on the documentaries?

RQ3: What topics related to TCM appear most frequently in the audience comments? How are emotions distributed across these topics?

These research questions are examined through sentiment analysis, topic modelling and comparative analysis of YouTube audience comments, thereby revealing how TCM is received and disseminated in the global new media environment.

3 Research Methods

To address the above research questions, this study adopts a mixed-method approach that combines quantitative and qualitative analysis to systematically examine four TCM documentaries on YouTube along with their audience comments. The research process is divided into three steps: first, quantitative analysis is carried out to examine the popularity of the four documentaries; second, quantitative analysis is conducted to identify the emotions and thematic patterns in the audience comments; finally, qualitative analysis is conducted to gain a deeper understanding of the audience’s attitudes and interpretations.

3.1 Quantitative Analysis of Documentary Popularity

To evaluate the dissemination of the four documentaries, this study draws on several key social media indicators. Specifically, the view count functions as a direct measure of audience reach and exposure. Meanwhile, the comment count reveals the degree of active audience participation and discursive engagement, while the like count captures immediate resonance and approval from viewers. By comparing these indicators, this study identifies differences in audience participation and popularity among the four documentaries, and further explores the potential factors shaping these differences, ranging from platform-specific factors such as the subscriber base of the uploading channels to content features of the documentaries themselves.

3.2 Quantitative Analysis of Audience Comments

The second step focuses on the audience comments, employing sentiment analysis and topic modeling to provide a more comprehensive picture of the multiple dimensions of audience cognition and emotion toward TCM.

1) Preparation for Quantitative Analysis

Data collection and cleaning serve as preparation for subsequent sentiment analysis and topic modeling. The comment data of the four documentaries were collected with the aid of Python scripts. As of September 12, 2025, a total of 1,438 original comments were retrieved. Subsequently, the data were cleaned. First, invalid comments containing only emojis or other non-text content were deleted. Second, given YouTube’s global audience, which includes a small portion of comments in French and Spanish, only English comments were retained to ensure the linguistic consistency of the analysis. After cleaning, 1,289 valid comments were obtained. Finally, text standardization was performed, including deleting special characters, correcting spelling errors, restoring word forms through lemmatization, and removing stop words.

2) Sentiment Analysis

In this study, the VADER tool is used to analyze the sentiment of audience comments. VADER is specifically designed for social media text and is generally more accurate and efficient than TextBlob and traditional NLTK methods when handling short social media texts. Its default threshold is 0.05, which is used to distinguish between positive and negative emotions (Bonta et al., 2019, p.6). Its compound sentiment score ranges from -1 to +1, with -1 indicating the most negative sentiment and +1 indicating the most positive sentiment. According to the criteria set by Hutto and Gilbert (2014, p.224), comments with a sentiment score of ≥0.05 are classified as positive, comments with ≤-0.05 are classified as negative, and comments that fall between these two scores are classified as neutral.

Sentiment analysis is performed at two levels. Document-level sentiment analysis evaluates the overall polarity of each comment to capture the overall attitude of the audience, while aspect-level sentiment analysis refers to identifying and evaluating audience attitudes toward specific aspects or features of a text rather than its overall sentiment (Alsaeedi and Khan, 2019, p.361). In this study, aspect-level analysis is based on the topics generated by BERTopic, which function as the specific aspects for evaluating audience sentiment. By calculating and comparing the sentiment distribution within each topic, the study reveals how the audience’s sentiment orientation and attitudes toward traditional Chinese medicine vary across different topic dimensions.

3) Topic Modeling

In this study, the BERTopic model is employed to identify topics in audience comments. BERTopic, a topic modeling technique widely adopted in recent years, uses the semantic representations of pre-trained language models to identify clearer and more interpretable topics based on semantic relationships within the text. Compared with traditional methods, BERTopic is more effective in handling short texts such as social media comments or user feedback (Egger and Yu, 2022, p.12). Through this process, the study identifies the main topics discussed by international audiences about TCM, as these topics not only show the main areas of attention among international audiences regarding traditional Chinese medicine, but also provide the basis for aspect-level sentiment analysis.

3.3 Qualitative Analysis of Audience Comments

In this step, an in-depth qualitative analysis of carefully selected representative comments is carried out to provide more contextual information for quantitative results. The selection of comments is based on criteria such as the completeness of information, the clarity of viewpoints, and engagement indicators such as the like counts, ensuring the representativeness of the sample. Subsequently, a close reading of these comments is conducted to reveal the different ways in which international audiences understand and emotionally respond to TCM across various discursive contexts.

4 Popularity of the Four Documentaries

This section first presents the quantitative results of the four documentaries’ popularity and then explores the external and internal factors contributing to the observed disparities.

4.1 Quantitative Analysis of Popularity

Aggregate indicators such as views and comments effectively illustrate audience engagement patterns in analyses of user-generated content (Cha et al., 2007, p.3). Table 2 presents the key metrics of dissemination and engagement for the four documentaries.

TABLE 2  VIEW, COMMENT, AND LIKE COUNTS OF THE FOUR TCM DOCUMENTARIES

The popularity of the four documentaries can be directly observed through indicators such as views, comments and likes. Among them, Qi - The Art of Traditional Chinese Medicine has the highest dissemination performance, ranking first in all the three indicators. The documentary has recorded 1.4 million views, 1,162 comments and 19,000 likes. Its large number of views places it in the category of “hit” or high-exposure videos (Khan, 2017, p.238). This film is not only widely viewed but also has a high audience participation, indicating its strong appeal among international audiences.

In contrast, The Tale of Chinese Medicine S1 has recorded about 141,000 views and 3,020 likes, but generated only 95 comments. This significant gap between a high like counts and a very low comment counts suggests that while the documentary received considerable praise, its content did not stimulate extensive discussion or interaction among viewers. The Science Behind Traditional Chinese Medicine recorded 90,000 views, 1,900 likes, and 153 comments. Notably, its ratio of comments to views is significantly higher than that of The Tale of Chinese Medicine S1, indicating that the film prompted more active discussion. Finally, Journey to the West has the lowest popularity, with only 1,100 views, 28 likes, and 2 comments. Such low audience participation indicates that the film failed to generate effective communication or interaction, suggesting its limited influence among international audiences.

Although the four documentaries share the same theme and were released around the same period, their popularity varies significantly. The high level of attention to Qi contrasts sharply with the very low popularity of Journey to the West, which indicates that the issue is not the international audiences’ rejection of traditional Chinese medicine itself, but rather differences in narration and content. This necessitates an exploration of the underlying reasons for these disparities, which will be discussed in the next section.

4.2 Discussion of Underlying Factors affecting Popularity

As mentioned above, the significant disparities in popularity cannot be fully explained by numerical indicators alone; the differences must therefore be attributed to other key factors, which can be categorized as those related to content and those external to it.

1) Initial Advantage from the Release Channel’s Subscriber Base

According to Borghol et al., “although the content of the item plays an important role, it has been widely recognized that other ‘content-agnostic’ factors can also have a substantial impact on popularity” (2012, p.1186). Factors such as the uploader’s subscriber base and the size of their social network have a direct impact on a video’s popularity (Borghol et al., 2012, p.1186; Khan and Vong, 2014, p.642).

First, uploaders with a larger subscribers are more likely to gain more views immediately upon release, thereby obtaining an initial exposure advantage. This first-mover advantage is crucial for triggering the platform’s recommendation algorithm, which in turn promotes the snowball effect of content dissemination (Borghol et al., 2012, p.1187). Second, a channel’s “reputation” on social media is typically reflected by external indicators such as subscriber count and accumulated views, enhancing audience trust and click-through rates (Kietzmann et al., 2011, p.247).

TABLE 3  BASIC INFORMATION OF THE DISTRIBUTION CHANNELS FOR THE FOUR TCM DOCUMENTARIES

Table 3 presents the basic information about the distribution channels. As shown in the table, wocomoDOCS, the distributor of Qi, holds a clear lead in terms of the subscriber count and total views. Therefore, Qi has obviously benefited from its large network size, which has significantly contributed to its strong popularity. The channel with the second-largest number of subscribers is Stash – Free Documentaries. However, despite these favorable external conditions, the dissemination performance of Journey to the West is extremely poor. This demonstrates that channel advantages alone cannot guarantee a documentary’s popularity, and that dissemination outcomes are also shaped by other factors such as content.

In contrast, The Tale of Chinese Medicine Official Channel and LAGP Films have achieved considerable engagement despite their limited subscriber bases. The comments and likes for The Science Behind Traditional Chinese Medicine are relatively active, indicating that small channels can still receive positive audience feedback when their content has strong appeal.

In conclusion, although a channel’s scale provides an important initial advantage for the dissemination of documentaries, it is not the sole factor determining popularity. Evidence shows that broad dissemination ultimately depends on a documentary’s capacity to attract audience interest and overcome cultural barriers. Therefore, in the next section, the analysis turns to the content of the documentaries themselves and to explore its content-related factors.

2) The Appeal of Authenticity and Life Experience

Among the four documentaries, the most notable feature of Qi is its emphasis on authenticity and life experience. The film adopts an observational documentary style, recording the daily life of ordinary Chinese people, including consulting doctors, dispensing medicine, receiving treatment, and practicing Qigong. This straightforward and accessible presentation, rooted in the reality of Chinese society, not only reduces cultural distance but also satisfies the curiosity of Western audiences about China and traditional Chinese medicine. Emotional narration and human-centered realism are the main driving forces behind its widespread dissemination.

Journey to the West, in contrast, relies heavily on expert commentary and technical terminology, focusing primarily on debates over the scientific validity of traditional Chinese medicine in a Western context. Although this approach gives the film a certain authority, the lack of experiential scenes limits the audience immersion and weakens its appeal to the general audience. The Science Behind Traditional Chinese Medicine adopts an academic format, structured around lectures and interviews with MIT scholars and other experts. By emphasizing scientific rigor and empirical verification, the film strengthens the credibility of traditional Chinese medicine in modern contexts. However, it avoids personal narrative and emotional engagement, imposing higher cognitive demands on the audience, thereby limiting its accessibility and viewer connection.

In short, authenticity, accessible narration, and daily reality are crucial when introducing traditional Chinese medicine to international audiences, most of whom are unfamiliar with it and tend to resonate more deeply with experiential narratives than with academic explanations. This finding shows the importance of narrative strategies in cross-cultural communication as human-centered narratives rooted in real life can reduce cultural and cognitive barriers and thereby promote deeper understanding and reception.

3) The Role of Authoritative Experts in Enhancing Credibility

Among the two academic documentaries, the difference in the popularity between The Science Behind Traditional Chinese Medicine and Journey to the West is particularly striking. Although the distributing channel of The Science Behind Traditional Chinese Medicine is much smaller, its popularity exceeds that of Journey to the West. While the two documentaries share similar academic themes and styles, they differ significantly in their expert support. The former features an authoritative scholar from the Massachusetts Institute of Technology (MIT), whereas the latter relies primarily on experts from British medical, educational, and acupuncture institutions.

The participation of the MIT scholar is crucial because the institution’s reputation greatly enhances the academic credibility and international authority. As a globally recognized research university, MIT functions as a high-prestige source, “the extent of agreement is usually higher when the statements are attributed to ‘high prestige’ sources” (Hovland and Weiss, 1951, p.635). For audiences seeking a scientific explanation, this institutional recognition makes The Science Behind TCM more convincing than Journey to the West, whose expert group has a relatively lower international reputation. This indicates that the identity of experts and the reputation of their institutions not only shape the documentary’s professional image but also serve as crucial signals of trust and credibility, thereby influencing its dissemination among international audiences.

5 Audience Reception and Perceptions of TCM

The previous section analyzed the popularity of the TCM documentaries and the causes of their differing popularity. This section focuses on audience comments and systematically examines how international audiences receive and interpret the TCM culture presented in these documentaries. The analysis proceeds from four dimensions: first, macro-level sentiment analysis is conducted to reveal the audience’s overall attitudes; second, the core issues of audience concern are identified through topic modeling; third, topic modeling and sentiment analysis are integrated to reveal subtle emotional tendencies under different themes; and finally, qualitative interpretation is carried out to further investigate how international audiences understand and respond to traditional Chinese medicine culture.

5.1 Overall Sentiment of the Audience

“Sentiment analysis, also called opinion mining, is the field of study that analyzes people’s opinions, sentiments, evaluations, appraisals, attitudes, and emotions towards entities such as products, services, organizations, individuals, issues, events, topics, and their attributes” (Liu, 2022, p.7). Based on the sentiment analysis of the 1,289 audience comments, Table 4 summarizes the results, detailing the counts and mean scores for each category. The distribution of overall sentiment scores is illustrated in Figure 1.

TABLE 4  THE RESULTS OF OVERALL SENTIMENT ANALYSIS

FIG. 1  DISTRIBUTION OF OVERALL SENTIMENT SCORES

Figure 1 illustrates the distribution of sentiment scores. In general, positive comments account for the majority, about 53% of the total, and are mainly concentrated in the high score range of 0.4 to 1.0. This reflects the large number of comments expressing strong appreciation and support for TCM culture. By contrast, negative comments make up the smallest proportion, about 20%, and are primarily concentrated in the range of –0.2 to –0.8, indicating relatively mild negative emotions that express dissatisfaction or criticism rather than radical rejection. This distribution indicates that although the documentaries received some criticism, their overall feedback remains positive. In sum, the four documentaries have received predominantly positive evaluations, indicating that international audiences generally show a high level of acceptance and recognition of the traditional Chinese medicine culture presented.

5.2 Key Topics of Audience Interest

BERTopic can automatically cluster user comments based on semantic similarity. After many rounds of testing, only two topics proved stable, while the remaining topics were either too small in number or not semantically clear enough. Therefore, these two main topics are reserved for subsequent analysis. Figure 2 shows these two topics and their associated keywords.

FIG. 2  KEYWORDS ASSOCIATED WITH EACH TOPIC

As shown in Figure 2, audience comments are mainly concentrated in two different dimensions. Topic 0 revolves around traditional Chinese medicine and culture. The keywords include “medicine,” “medical,” and “doctor,” reflecting audiences’ strong interest in the medical information and cultural elements presented. Keywords such as “patient,” “health,” “treatment,” and “cure” further show that audiences are highly interested in the treatment and efficacy of traditional Chinese medicine. Notably, the success of Qi, which uniquely depicts patients’ consultation experiences, supports the view that this theme aligns closely with audience interests and contributes to higher engagement.

Topic 1 concerns the viewing experience and emotional feedback, focusing on audiences’ affective responses. Keywords such as “documentary,” “thank,” “enjoyed,” “interesting,” and “fascinating” confirm the earlier finding that positive comments account for the majority, as audiences frequently express their appreciation and affection for TCM culture as well as for the quality of the film production.

Taken together, these two topics illustrate a multidimensional reception: audience discussions engage directly with TCM culture (Topic 0), while also incorporating emotional and experiential responses to the viewing experience (Topic 1).

5.3 Aspect-Level Sentiment Analysis Across Topics

To overcome the limitations of broad sentiment analysis, a more fine-grained approach is necessary. “Both the document-level and the sentence-level analyses do not discover what exactly people liked and did not like. Aspect level performs finer-grained analysis. The goal of this level of analysis is to discover sentiments on aspects” (Liu, 2022, p. 11). To capture more precise audience attitudes, this study combines topic modeling with sentiment analysis to explore in greater depth the emotional tendencies of audiences under different topics. The proportions of the two topics, along with their sentiment distributions and mean values, are presented in Figures 3 and 4.

FIG. 3  TOPIC PROPORTIONS

As shown in Figure 3, discussion of the core content of the documentary, namely Topic 0, “traditional Chinese medicine and culture,” accounts for the highest proportion, about 71.3%. This finding confirms that audience comments primarily focus on the thematic presentation and cultural value of traditional Chinese medicine. Topic 1, “viewing experience and feedback,” accounts for about 28.7%. Although this proportion is relatively small, it still indicates that audiences are willing to share their emotional responses and viewing experiences of the work.

FIG 4  SENTIMENT DISTRIBUTION AND MEAN VALUES BY TOPIC

Figure 4 shows the sentiment distribution and average scores of the two topics. For Topic 0 titled “traditional Chinese medicine and culture,” audience emotions show greater polarization. Positive comments account for 50.4%, and negative comments account for 22.1%. The average score of positive comments is 0.58, while that of negative comments is -0.52, indicating that the audience’s attitudes toward both positive and negative aspects are fairly clear. In contrast, the evaluation of Topic 1 titled “viewing experience and feedback” is more consistently positive, with about 61.9% of the comments classified as positive and only 7.5% as negative. The small proportion of negative comments in Topic 1 indicates that audiences are generally satisfied with the production quality and viewing experience of the film, whereas the higher proportion of negative comments in Topic 0 highlights differences of opinion and criticism regarding the film’s cultural and scientific aspects.

5.4 Qualitative Analysis of Audience Comments

The preceding quantitative analysis provides a broad overview of audience attitudes toward TCM. Furthermore, to better understand audiences’ specific views and evaluations, this section conducts a detailed qualitative interpretation focusing on the two core dimensions identified in the topic modeling.

1) Audience Discussions on TCM Culture

Audience discussions on traditional Chinese medicine constitute a substantial portion of the overall comments. While the general sentiment is predominantly positive, a notable share of negative views is also present. A closer reading of the comments shows that positive evaluations tend to revolve around cultural value and personal experience, whereas negative evaluations are largely centered on issues of scientific validity and ethical concerns.

On the one hand, positive evaluations of TCM culture mainly focus on three aspects. First, traditional Chinese medicine culture and TCM practitioners have earned audience respect. Through the presentation of traditional Chinese medicine, the documentaries have deepened many audiences’ understanding of the value and significance of TCM and its practitioners. As one user stated, “More respect TCM... goes to root of problem1” (georgeduncan5178). This approach to addressing root causes has further enhanced the reputation of TCM. Some viewers also emphasized that TCM culture and traditional Chinese wisdom represent valuable cultural heritage.

Second, the documentaries have stimulated audience curiosity and satisfied their interest. For example, user bayleeg9905 noted an interest in “Chinese medicine and their passion and meticulous ways in harvesting these often rare, hard to find herbs”. Others expressed an interest in seeking TCM treatment, as one user said, “I have bladder issues that are destroying my life and I’d love to find a TCM” (sportluver98).

Third, many audiences affirmed the effectiveness of TCM through personal experience. For instance, user elizabethszymanska2107 stated, “I go to acupuncture every week too. I can’t imagine life without. I would be dead a long time ago if I did not meet with this art in my life.” These personal accounts demonstrate the practical efficacy of TCM therapies and enhance their credibility.

On the other hand, negative emotions are mainly concentrated on two aspects. The first concerns the scientific validity of TCM. A small number of viewers still doubt that traditional Chinese medicine lacks scientific support. For example, user Ṽïkiṇḡ--ṝ-w stated, “Traditional Chinese medicine doesn’t work it has no evidence in science.” This reveals persistent challenges in overcoming scientific skepticism toward TCM.

The second issue relates to stereotypes about rare animal-derived medicinal materials. Some comments question or criticize TCM for contributing to the overhunting and the endangerment of wildlife. For instance, user joeblack363 claimed, “traditional Chinese medicine is also one of the biggest exporters of illegal ivory and rhino horns.” Such statements suggest that, drawing on limited information sources, some international audiences may associate TCM with illegal wildlife trade. This tendency to treat isolated historical cases as representative practices can contribute to the impression that TCM relies heavily on rare animal materials. However, systematic analyses of the crude drug materials listed in the Pharmacopoeia of the People’s Republic of China show that plant-derived medicinal substances account for 535 items, or 86.85% of all entries, whereas animal-derived materials constitute only 6.98% (Luo et al. 2024, p.1350). As another user, marttalkintu2035, observed, misconceptions regarding the composition of Chinese herbal medicines call for clarification through scientific evidence provided by authoritative academic and regulatory institutions. These patterns indicate that certain stereotypes persist among the international audiences, underscoring the need for more accessible and accurate information in cross-cultural communication.

2) Audience Responses to Viewing Experience

The second major topic in audience comments centers on the viewing experience. In this aspect, positive evaluations mainly reflect audiences’ favorable assessments of the quality of the film production. Audiences described these films as “outstanding,” “wonderful,” and “fascinating,” and praised them for their rich information, diverse content, and well-crafted music and cinematography. For example, user vbello7496 commented, “Great cinematic video with full information. It’s so amazing to watch, thank you.”

Negative comments, by contrast, primarily focus on technical problems related to subtitles and dubbing. For instance, the English dubbing of the film Qi was not accompanied by English subtitles, which affected the viewing experience. Users explicitly requested the addition of subtitles (mustafaburhan5444) and pointed out that using subtitles is more respectful than dubbing because it preserves the speaker’s authentic voice (amethyst4786). The absence of subtitles is the main reason for audiences’ negative feedback regarding the viewing experience.

6 Conclusion

In conclusion, this study conducts a systematic analysis of the popularity and audience reception of four TCM documentaries on YouTube. The results reveal significant differences in their popularity. These disparities stem primarily from two types of factors: first, variations in initial exposure tied to the subscriber base of the release platforms; second, the narrative strategies and content presentation methods employed in the documentaries themselves. For instance, Qi, relying on a release platform with a larger subscriber base, presents traditional Chinese medicine culture and treatment experiences in a narrative style that is rooted in life experience and easy to understand, thus achieving over a million views and highly active discussions. Meanwhile, the Science Behind Traditional Chinese Medicine, despite having a weaker subscriber base and lacking initial exposure, still achieves considerable popularity thanks to the participation of authoritative experts and its strong scientific explanatory capabilities. These comparisons indicate that with substantive content, appropriate narrative strategies, and support either from platform scale or expert credibility, documentaries on traditional Chinese medicine have the potential to achieve effective dissemination among international audiences.

In terms of overall emotional attitudes, the audience comments are mostly positive. On the one hand, most viewers express recognition of traditional Chinese medicine culture and its efficacy, and some comments also demonstrate strong interest in traditional Chinese medicine knowledge and a desire for further understanding. In addition, the audiovisual presentation of the documentaries has received widespread praise. This indicates that traditional Chinese medicine is showing a positive and sustainable development trend in its overseas dissemination. On the other hand, the study also reveals that scientific skepticism and cultural stereotypes remain. Some viewers question the scientific basis of traditional Chinese medicine or associate it with unverified empirical practices; others repeatedly link traditional Chinese medicine with the use of endangered animals. Although the number of these negative views is limited, if they are not addressed promptly and authoritatively, they may solidify into deeper misunderstandings and undermine the positive outcomes of the global dissemination of traditional Chinese medicine.

Therefore, the international dissemination of traditional Chinese medicine requires more targeted strategies in the future. From the narrative perspective, a dissemination approach centered on life-like scenarios and personal stories can effectively reduce cultural distance and evoke emotional resonance. From an academic perspective, in the context of persistent scientific skepticism, expert-led explanations characterized by academic rigor remain indispensable, as they enhance credibility and help clarify misunderstandings. These two approaches are not mutually exclusive but should operate together as complementary dissemination strategies. At the same time, the quality of subtitles, language accessibility and cultural adaptability remain key factors in cross-cultural understanding and must be given due attention. Only by balancing scientific rationality with humanistic care and consistently respecting cultural differences can traditional Chinese medicine continue to enhance its global influence and achieve cross-cultural recognition.

Despite its contributions, this study has several limitations. First, the analysis relies exclusively on English-language comments, which represent only a portion of the global audience and may omit perspectives expressed in other linguistic and cultural contexts. Second, the study examines only four documentaries, so its findings may not be generalizable to all audiovisual works related to traditional Chinese medicine. Third, the data were collected at a single point in time, limiting the study’s ability to capture temporal variations in audience attitudes and discussion patterns. Finally, the analysis is restricted to YouTube, whereas other platforms such as Facebook, TikTok may present different dissemination dynamics. Future research could expand to cross-linguistic, cross-platform, and longitudinal datasets, and adopt comparative approaches to develop a more comprehensive understanding of the global dissemination and reception of traditional Chinese medicine.

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