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Communication Research Reports
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/rcrr20
Predicting telephone anxiety: use of digital
communication technologies, language and
cultural barriers, and preference for phone calls
Leanna T. Kim & Sang-Hwa Oh
To cite this article: Leanna T. Kim & Sang-Hwa Oh (2023): Predicting telephone anxiety: use of
digital communication technologies, language and cultural barriers, and preference for phone
calls, Communication Research Reports, DOI: 10.1080/08824096.2023.2221845
To link to this article: https://doi.org/10.1080/08824096.2023.2221845
Published online: 07 Jun 2023.
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Predicting telephone anxiety: use of digital communication
technologies, language and cultural barriers, and
preference for phone calls
Leanna T. Kim and Sang-Hwa Oh
ABSTRACT
This study examines telephone anxiety, a form of communica-
tion apprehension associated with making and taking a phone
call. We theorize that the use of digital communication technol-
ogies can inuence how anxious one feels about speaking on
the phone. Supporting our theorization, we found a positive
correlation between using digital technologies and telephone
anxiety. Also, such a correlation was greater among non-native
English speakers, indicating that the eect of using digital com-
munications could be greater among people with a language
barrier. Lastly, ndings demonstrated that telephone anxiety
might lead to preferring other forms of communication over
a phone conversation.
KEYWORDS
Telephone anxiety; digital
technologies; phone
conversation; language
barrier; millennials
Telephone anxiety refers to the anxiety associated with speaking on the phone
in an actual or anticipated telephone conversation (Steele & Reinsch, 1983).
The concept appeared in academic literature as early as in the 1950s (e.g.,
Harris, 1957); however, with only a few exceptions (Fielding, 1990; Steele &
Reinsch, 1983), little attention has been given to telephone anxiety in empirical
investigations. With the wide adoption of digital communication technologies
in recent decades, researchers have increasingly reported observations of
telephone anxiety, demonstrating its prevalence particularly among younger
individuals (K. R. Lee et al., 2018). A survey of U.K. office workers in 2019
(Phone Anxiety Affects Over Half of UK Office Workers, 2019) reported that
while about 40% of baby boomers experienced anxious thoughts on taking
a phone call, as much as 76% of millennials experienced the same thoughts,
suggesting telephone anxiety might be greater among younger than older
individuals.
Using a national survey of U.S. adults, we examine potential causes and
consequences of telephone anxiety. More specifically, the purpose of our study
is to demonstrate how the increasing use of text-based digital communications
might have contributed to the growing anxiety over oral conversation in
a phone call, particularly among younger individuals. Our study brings
a renewed attention to telephone conversations, which seem to be almost
CONTACT Sang-Hwa Oh sanghwa2@illinois.edu Charles H. Sandage Department of Advertising, College of
Media, University of Illinois at Urbana-Champaign
COMMUNICATION RESEARCH REPORTS
https://doi.org/10.1080/08824096.2023.2221845
© 2023 Eastern Communication Association
forgotten in the rapidly changing communication environment today.
Examining how an old technology, like a telephone call, has been replaced
by newer technologies, as well as investigating the psychological processes
underlying such a transition, may provide important implications for under-
standing the structuring of the future society. The same anxiety that affects
a telephone conversation may also lead to an active avoidance of face-to-face
interactions among younger individuals, facilitating a transition to
a contactless society in the near future.
Digital communication technologies and telephone anxiety
By nature, speaking on the phone with another person, particularly with
a stranger, can be an anxiety-inducing experience (Fielding, 1990). The pre-
sence of the other person on the line may create the feeling of being constantly
judged, and the pressure to maintain a positive impression becomes a source
of anxiety (S. Lee et al., 2014). Similarly, a phone conversation requires one to
think on his or her feet without having enough time to gather thoughts or edit
the dialogue and having to respond quickly and adequately can lead to a high
level of anxiety (Leary, 1983). On the contrary, by eliminating or delaying the
reaction from the other person, most text-based digital technologies allow
users to communicate with reduced fear of instant rejection or disapproval
and instead focus on crafting an accurate and effective message (Ellison et al.,
2006). These technologies range from using e-mails, text messages, and instant
messengers to opening a mobile app to order a pizza instead of calling the
restaurant.
Telephone anxiety in our study is conceptualized as being associated with
the nature of communication process rather than with the device itself. In
large part, it is the oral and synchronous communication process that pro-
duces anxiety in a phone conversation, and this is distinguishable from the
text-based and/or asynchronous processes in most digital communications
today. Although cellphones utilize digital signals and technologies, speaking
on a cellphone is an oral and synchronous process and similar, in this regard,
to traditional landline phone conversations rather than to other forms of
digital communications. In addition, cellphones have made it even easier to
avoid phone calls. Users can easily decline incoming calls by silencing a call
and sending it directly to voicemail. Also, the caller identification service
allows users to decline an incoming call more comfortably without being
worried too much about accidentally rejecting an important phone call.
Again, the dichotomy in our study between telephone conversations vs. digital
communications is based upon the nature of communication process rather
than the technologies used in different devices.
As such, digital technologies provide a non-threatening communication
environment, where users do not have to deal with as much anxiety as they
2L. T. KIM & S.-H. OH
would experience in voice calling (Shalom et al., 2015). However, while digital
communications allow users to avoid telephone anxiety, they may not help
them overcome the anxiety. Perhaps, one of the most effective ways to over-
come telephone anxiety is to make more phone calls (Romm, 2020), as the
anxiety tends to be associated largely with a lack of experience (Dudley et al.,
1993).
The large availability of digital technologies may represent reduced oppor-
tunities to use and practice voice calling. Therefore, those who rely heavily on
digital communications may remain less experienced with talking on the
phone, feeling more anxious about it (K. R. Lee et al., 2018). This does not
mean that the use of digital technologies will necessarily increase telephone
anxiety among users. Instead, we theorize that digital technologies may lead
people, particularly younger individuals, to remain anxious about speaking on
the phone. Also, we do not rule out the possibility of a reverse causation. As
anxious individuals will rely more heavily on digital technologies as a less-
stressful alternative (Pierce, 2009; Skierkowski & Wood, 2012), greater tele-
phone anxiety will likely lead to a more frequent use of digital communica-
tions, which in a cyclical process can lead to remaining anxious about voice
calls. Although the use of digital communications and telephone anxiety seem
to affect each other (digital communications ←→ anxiety), our focus in this
study will primarily be on demonstrating that use of digital communications
can affect the level of telephone anxiety (digital communications→anxiety).
Younger adults today have grown up with a large availability of digital
technologies and tend to rely more heavily than older individuals on those
technologies for communication (Pendleton et al., 2021; Prensky, 2001), while
less willing to use a voice call (Jarvis et al., 2020). Therefore, there might be
a lack of sufficient opportunities among younger individuals to become
experienced with speaking on the phone and overcome telephone anxiety
(K. R. Lee et al., 2018). On the contrary, older adults had to use voice call
often, as it used to be one of only a few personal telecommunication technol-
ogies available before the digital age, so that they may have become much
experienced with talking on the phone, feeling less uncomfortable with it. As
such, finding a significant correlation between age and telephone anxiety, with
younger individuals remaining more anxious than older individuals, can
provide at least indirect evidence for our proposed causal direction. We test
the following hypotheses:
H1: There will be a positive correlation between the use of digital commu-
nication technologies and the level of telephone anxiety.
H2: Younger individuals will report experiencing a higher level of telephone
anxiety than older individuals.
COMMUNICATION RESEARCH REPORTS 3
Language and cultural barriers
Speaking on the phone may create greater anxiety among those whose
native language is not English and those who were born and raised in
a foreign country. Foreign language anxiety involves a fear of being
unable to accurately comprehend a conversation and articulate ideas; it
also relates to a fear of being negatively evaluated by others (Aichhorn
& Puck, 2017). Those fears can be expected in a phone conversation,
and language barriers may lead to greater telephone anxiety. Also,
cultural differences exist in the ways people communicate on the
phone (Fielding, 1990), and communicating effectively on the phone
requires cultural proficiency. A phone conversation involves an under-
standing of subtle manners; one must know how to segue from the
greeting to the next stage, how to interrupt politely, and how to end the
conversation nicely, all of which can vary from one culture to another
(Romm, 2020). Many immigrants can become anxious about talking on
the phone because of cultural differences (Young, 1992). We test the
following hypotheses:
H3a: Non-native English speakers will report experiencing a higher level of
telephone anxiety.
H3b: Immigrants will report experiencing a higher level of telephone
anxiety.
Moderation eects
Using or not using digital technologies frequently can make a lager
difference in telephone anxiety among those who are more susceptible
to telephone anxiety in the first place, such as younger individuals
(K. R. Lee et al., 2018), non-native English speakers (Aichhorn &
Puck, 2017; Cheng et al., 1999), and immigrants (Young, 1992). In
addition to examining the correlation between use of digital technolo-
gies and telephone anxiety, we investigate whether the correlation is
moderated by these three personal factors:
H4: The correlation between the use of digital technologies and telephone
anxiety will be greater among (a) younger individuals, (b) non-native English
speakers, and (c) immigrants.
4L. T. KIM & S.-H. OH
Telephone anxiety and preference for phone calls
Finally, we examine whether telephone anxiety is negatively associated with
preferring a phone call over texting or other modes of communications on
a variety of occasions. We suggest a lower level of preference for phone calls
may not simply be a matter of inconvenience but an outcome of anxiety. We
hypothesize:
H5: There will be a negative correlation between the level of telephone
anxiety and preferring a phone call over other forms of communication.
Methods
Sample
Data for this study came from a survey distributed by Qualtrics in 2021.
Members of the Qualtrics national panel were recruited based on their age,
gender, and race. Invitation e-mails served as an informed consent, and IRB
approval was obtained in March 2021. Those who failed to pass attention
check questions were immediately directed to the end of the survey. Using the
median completion time (10 minutes), those who spent less than 5 minutes on
the entire survey (one-half of the median) were removed from our sample,
which was consistent with Qualtrics’ speeding check practice. In addition,
straight-liners were eliminated from the final sample (N = 520).
Measurements
Items to measure telephone anxiety were adopted from Fielding’s (1990)
Telephone Apprehension Inventory. Respondents were asked how strongly
they agreed (1=strongly disagree; 5=strongly agree) with: (a) “I hurry to finish
the conversation when I’m communicating by phone;” (b) “When I have to
communicate by phone, I grow nervous and uncomfortable;” (c) “I feel rushed
and pushed when I communicate with people on the phone;” (d) “I feel it is
difficult to converse over the phone;” (e) “I feel misunderstood when I use the
phone;” (f) “I feel anxious when communicating with people by phone.” These
six measures were averaged into a single index (α=.95; M = 2.88; SD = 1.30).
We then measured the frequencies (1=never; 5=all the time) of using digital
technologies that could serve as an alternative to oral telephone communica-
tions: (a) e-mails; (b) multimedia or instant messaging; (c) direct messaging of
social media; (d) text messaging. These four items were also averaged into
a single index (α=.71; M = 3.69; SD=.92).
COMMUNICATION RESEARCH REPORTS 5
Preference for phone calls was measured by asking respondents how much
they preferred a phone conversation over other modes of communication on
five specific occasions: (a) speaking with family and friends (1=prefer texting,
5=prefer speaking on the phone; M = 3.76, SD = 1.31); (b) speaking with a new
acquaintance (1=texting, 5=on the phone; M = 3.47, SD = 1.36); (c) speaking
with customer service (1=an automated service, 5=a real person on the phone;
M = 4.07, SD = 1.20); (d) ordering food (1=online or through an app, 5=on the
phone; M = 3.44, SD = 1.40); e) making a doctor’s appointment (1=online or
through an app, 5=on the phone; M = 3.91, SD = 1.28).
Respondents being a non-native English speaker and being an immigrant
were measured by asking whether English was their second language (19.6%)
and whether they were born and raised in another country (14.6%).
Demographics included: age (Median = 42.50 years), gender (51.0% female),
income (Median=$50,000 to $74,999), race (White 62.1%, Black 12.1%,
Hispanic 16.7%, Asian 6.0%, Other 3.1%), and education (Median=associate
degree).
Findings
To test H1 and H2, we used hierarchical regression, where the level of
telephone anxiety was regressed onto the use of digital technologies and
demographics including respondents’ age (see Table 1). To test the effects of
language and cultural barriers, respondents being a non-native English
speaker (H3a) and being an immigrant (H3b) entered the regression as well.
Finally, a series of potential interaction terms entered the regression to test
moderating roles of age (H4a), being a non-native English speaker (H4b), and
being an immigrant (H4c).
Supporting H1, the use of digital technologies was positively and signifi-
cantly correlated with telephone anxiety (β=.216). However, this significant
correlation alone cannot fully support our proposed causal direction (digital
communications→telephone anxiety). In this regard, it is necessary to report
that as predicted in H2, age was negatively associated with telephone anxiety
(β=-.341). Younger respondents being more anxious than older respondents
may provide indirect evidence for our proposed causal direction and demon-
strate that the use of digital communications can affect the level of telephone
anxiety.
To further examine the relationships, the use of digital communications and
the level of telephone anxiety were regressed onto respondents’ age, and
Figure 1 presents LOESS fit lines. The relationship between age and the use
of digital communications (the graph at the top) shows that there are little
variations in the use between ages 20 and 40, but it begins to decline rapidly
after the age of 40. The relationship between age and telephone anxiety (the
graph at the bottom) shows a similar curve. There are little differences in
6L. T. KIM & S.-H. OH
telephone anxiety between ages 20 and 40, but it begins to decline rapidly after
the age of 40. The 20–40-year-old millennials, who were born between around
1980 and 2000 and grew up with access to a verity of digital technologies, seem
to be less experienced with talking on the phone and remain more anxious
about it than older individuals. Again, these findings provide additional
support for our theorization that the use of digital communications may
Figure 1. LOESS fit lines.
COMMUNICATION RESEARCH REPORTS 7
allow people to avoid voice calls, making them remain anxious about phone
conversations.
Findings show that neither being a non-native English speaker (β=.029) nor
being a foreign immigrant (β=.039) was significantly associated with telephone
anxiety; H3a and H3b were not supported (see Table 1); H3a and H3b were
not supported. Supporting H4b, the effect of using digital communications
tended to be greater among non-native English speakers, though such an
interaction (β=.103) was only marginally significant (p = .073). Neither age
(β=.025) nor being an immigrant (β=-.035) indicated a significant interaction;
H4a and H4c were not supported.
To test H5, preference for phone calls was regressed onto the level of
telephone anxiety, along with demographics and language and cultural bar-
riers (see Table 2). Supporting H5, there was a negative and significant
correlation between telephone anxiety and preferring a phone conversation
over other modes of communication when speaking with family and friends
(β=-.161), a new acquaintance (β=-.134), customer service (β=-.253), and
making a doctor’s appointment (β=-.109). These findings indicate that tele-
phone anxiety may in fact lead to preferring other forms of communication
over a phone call.
Table 1. Regression predicting telephone anxiety (N = 520).
Telephone Anxiety
β (t)p
Demographics
Age -.341 (-8.271) <.001
Gender (female) -.092 (-2.147) .032
Income .010 (.216) .829
Race (base=Whites)
African American -.081 (-2.009) .045
Hispanic -.086 (-2.016) .044
Asian -.117 (-2.637) .009
Other -.130 (-3.359) <.001
Education .102 (2.108) .036
Incremental R-Square (%) 23.8 [F(8,511) = 19.972] <.001
Language and Cultural Barriers
Being a Non-Native English Speaker .049 (.899) .369
Being a Foreign Immigrant .027 (.490) .624
Incremental R-Square (%) .3 [F(2,509)=.928] .396
Use of Digital Communication Technology
Digital Technology .216 (5.172) <.001
Incremental R-Square (%) 4.7 [F(1,508) = 33.488] <.001
Interactions
Digital Tech x Language .103 (1.796) .073
Digital Tech x Immigration -.035 (-.593) .554
Digital Tech x Age .025 (.640) .523
Digital Tech x Gender -.096 (-2.406) .016
Digital Tech x African American -.025 (-.626) .532
Digital Tech x Hispanic -.030 (-.708) .479
Digital Tech x Asian -.012 (-.264) .792
Digital Tech x Other .014 (.366) .714
Incremental R-Square (%) 1.5 [F(8,500) = 1.359] .212
Total R-Square (%) 30.3 [F(19,500) = 11.447] <.001
8L. T. KIM & S.-H. OH
Discussion
Our data revealed a positive correlation between the use of digital commu-
nications and telephone anxiety. Also, age was correlated with telephone
anxiety, with younger individuals – millennials in particular – being more
anxious than older individuals. This significant age-anxiety correlation may
not be fully explained if telephone anxiety affects the use of digital technologies
Table 2. Regressions predicting preference for phone calls (N = 520).
Preferring Phone Calls
Speaking with
Family/
Friends
Speaking with
a New
Acquaintance
Speaking with
Customer Service
Ordering
Food
Making
a Doctor’s
Appointment
β (t)p β (t)p β (t)p β (t)p β (t)p
Demographics
Age .234
(5.129)
<.001 .210
(4.737)
<.001 .152
(3.306)
.001 .126
(2.655)
.008 .110
(2.312)
.021
Gender (female) -.163
(-3.062)
<.001 -.236
(-5.372)
<.001 -.112
(-2.450)
.015 -.187
(-3.991)
<.001 -.180
(-3.803)
<.001
Income .115
(2.274)
.023 .060
(1.217)
.224 .017
(.343)
.732 .042
(.798)
.426 -.018
(-.335)
.738
Race
(base=Whites)
African
American
.060
(1.413)
.158 .078
(1.899)
.058 -.017
(-.387)
.699 .057
(1.301)
.194 .035
(.776)
.438
Hispanic .020
(.438)
.662 .006
(.144)
.886 -.052
(-.134)
.257 -.059
(-1.235)
.218 .041
(.859)
.391
Asian -.102
(-2.175)
.030 -.065
(-1.442)
.150 -.033
(-.694)
.488 -.062
(-1.269)
.205 -.086
(-1.750)
.081
Other .004
(.091)
.928 -.014
(-.342)
.732 .008
(.188)
.851 -.084
(-1.947)
.052 -.094
(-2.177)
.030
Education .093
(1.801)
.072 .198
(3.947)
<.001 .103
(1.971)
.049 .088
(-1.640)
.102 .044
(.819)
.413
Incr. R-Square
(%)
16.0 [F
(8,511) =
12.142]
<.001 21.0 [F
(8,511) =
17.011]
<.001 10.6[F
(8,511) =
7.567]
<.001 11.5 [F
(8,511) =
8.272]
<.001 8.3 [F
(8,511) =
5.777]
<.001
Lang. & Cul.
Barriers
Being a Non-
Native
English
Speaker
.028
(.493)
.622 .033
(.604)
.546 -.131
(-2.293)
.022 -.015
(-.251)
.802 -.011
(-.187)
.852
Being a Foreign
Immigrant
-.008
(-.133)
.894 -.038
(-.670)
.503 .070
(1.166)
.244 -.012
(-.189)
.850 -.098
(-1.588)
.113
Incr. R-Square
(%)
.0 [F
(2,509)
=.084]
.920 .1 [F
(2,509)
=.284]
.753 1.0 [F
(2,509)
= 2.981]
.052 .0 [F
(2,509)
=.143]
.867 1.0 [F
(2,509)
= 2.714]
.067
Telephone
Anxiety
Anxiety -.161
(-3.486)
<.001 -.134
(-2.984)
.003 -.253
(-5.444)
<.001 -.016
(-.340)
.734 -.109
(-2.255)
.025
Incr. R-Square
(%)
2.0 [F
(1,508)
= 12.149]
<.001 1.4 [F
(1,508)
= 8.904]
.003 4.9 [F
(1,508)
=
29.633]
<.001 .0 [F
(1,508)
=.116]
.734 .9 [F
(1,508)
= 5.086]
.025
Total R-Square
(%)
18.0 [F
(11,508)
= 10.112]
<.001 22.5 [F
(11,508)
=
13.390]
<.001 16.5 [F
(11,508)
= 9.126]
<.001 11.5 [F
(11,508)
= 6.022]
<.001 10.2 [F
(11,508)
= 5.223]
<.001
COMMUNICATION RESEARCH REPORTS 9
but not vice versa. Millennials being more anxious than older individuals can
be better explained by our theorization that heavy reliance on digital technol-
ogies has led them to remain anxious about phone conversations.
The negative age-telephone anxiety correlation did not seem to exist dec-
ades ago, before the digital age. For example, an analysis of U.K. survey data
(Fielding, 1990) indicated that there was no significant correlation between
age and telephone anxiety. The significant correlation today seems to be
attributed to the fast advances in and adaptation of digital technologies that
started in the late 1990s. Millennials did not have to make a phone call unless
necessary and used digital technologies instead for most communications
(Skierkowski & Wood, 2012), resulting in being less experienced with talking
on the phone and remaining more anxious about it than older individuals.
Again, this additional evidence supports our theorization that use of digital
communications can affect the level of telephone anxiety.
The correlation between using digital communications and telephone
anxiety was greater, though only marginally, among non-native English
speakers. Due to the language barrier, perceived benefits of digital commu-
nications can be greater among non-native English speakers, and their use
of digital communications can more rapidly replace phone conversations.
In result, frequent uses of digital technologies may likely hinder fast
integration into a larger community by allowing non-native English speak-
ers to avoid not only phone conversations but also face-to-face interactions
with native English speakers.
Finally, telephone anxiety was negatively associated with preference for
phone calls, suggesting that using an alternative mode of communication,
instead of a phone call, might not be simply a matter of convenience but an
outcome of escaping anxiety. New digital technologies seem to hinder users,
particularly younger individuals, from getting experienced with voice calling,
leading them to find the old technology to be an anxiety-producing experi-
ence, which in turn results in greater reliance on newer technologies.
It is necessary to mention some limitations of this study. First, although we
provided additional evidence to support our proposed causal direction, the
cross-sectional nature of our data does limit the ability to make strong causal
inferences. The ambiguity of causal directions reminds us not to over-interpret
the effect of digital technologies estimated in our study. Second, our opera-
tionalization of language and cultural barriers was all based on single-item
measures, which raises concern about the content validity as well as reliability.
Also, speaking English as a second language does not necessarily mean that the
person faces a language barrier. Similarly, merely being born and raised in
another country must be a weak proxy for a measurement of cultural barriers.
Our findings regarding language and cultural barriers should be considered as
preliminary at best, to be validated only in future research utilizing more
refined and comprehensive measurement items with enhanced reliability
10 L. T. KIM & S.-H. OH
and validity. Third, while telephone anxiety by nature may be more closely
related with speaking with an unidentified person, our measurements of
digital channels involved dyadic communications with known and well-
identified parties (e.g., instant messaging, direct messaging). This is certainly
part of the limitations of our study, and future research needs to investigate the
relationship between digital technology and telephone anxiety particularly in
the context of communicating with unknown strangers.
Also, our initial assumption that telephone anxiety would be prevalent
was not very consistent with our data. For example, our telephone anxiety
measure indicated a mean score of 2.88 on a five-point scale, which was
below the midpoint (3). Also, preferring a telephone conversation over
another technology ranged between 3.00 and 4.00 (above the midpoint)
across the five occasions examined, again indicating that most people are
still fine, rather than anxious, with speaking on the phone. This reminds us
to be cautious about making an implication about broader social and
generational trends.
Our study provides a hint for how digital technologies can facilitate
a transition to a contactless society, where most human interactions, such as
making transactions, engaging in occupational activities, obtaining new
knowledge, and developing relationships with others, take place without
a physical presence of involved human beings (J. Lee & Kim, 2021). In the
sense that face-to-face interactions and phone conversations occur in similar
contexts, particularly in terms of anticipated anxiety (Jin & Park, 2013),
frequent uses of digital technologies may lead to reduced opportunities to
get experienced with face-to-face communications, making users remain
uncomfortable with engaging in offline social interactions. Our findings can
be interpreted in a larger context of the transition to contactless social inter-
actions, and, arguably, younger individuals actively avoiding a phone conver-
sation can be an early indication of such a transition.
Author contribution
Leanna Kim: Original conceptualization and theorization, Literature review,
Questionnaire development, Co-writing original draft, Manuscript reviewing
and editing.
Sang-Hwa Oh: Supervision, Validation, Data curation, Formal analysis, Co-
writing original draft, Manuscript reviewing and editing
Disclosure statement
No potential conflict of interest was reported by the authors.
COMMUNICATION RESEARCH REPORTS 11
Notes on contributors
Leanna T. Kim is a student at Columbia University in the City of New York. Her academic
interests are in economics and political science.
Sang-Hwa Oh is assistant professor in the Charles H. Sandage Department of Advertising at
the University of Illinois at Urbana-Champaign. Her research is at the intersection of health/
risk communication, emerging media effects (including AI and VR), diffusion of (mis)infor-
mation, media literacy intervention effect, and roles of differential emotions in the commu-
nication process for public health promotion and social change.
ORCID
Sang-Hwa Oh http://orcid.org/0000-0003-0485-1163
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