Stephanie Cook
Stephanie H Cook
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Associate Professor of Social and Behavioral Sciences
Associate Professor of Biostatistics
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Professional overview
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Dr. Stephanie Cook’s overarching research focus is to understand how structural- and individual-level minority stressors contribute to mental health, physical health, and health behaviors across the life span. Further, she seeks to understand how features of close relationships can exacerbate or buffer the negative effects of minority stress on health. Her work primarily focuses on young adults transitioning to adulthood who are at the intersection of racial/ethnic and sexual orientation status. In addition, much of her current work examines the links between minority stress (i.e., daily experiences of discrimination) and biological markers of stress (e.g. cortisol and c-reactive protein).
Dr. Cook’s substantive methodological and statistical focus is in the development and application of longitudinal study designs (i.e., intensive longitudinal designs) for determining the ways in which dynamic changes in features of minority stress (e.g., daily and momentary discrimination events) are associated with changes in risk behaviors and physical health (e.g., sexual risk and substance use, pre-clinical cardiovascular disease, and biological stress) among racial/ethnic and/or sexual minority young adults.
Dr. Cook is the Director of the Attachment and Health Disparities Research Lab (AHDL) which is currently made up of about 20 undergraduate, graduate, and postdoctoral fellows. She developed an integrated theory of adult attachment (the Integrated Attachment and Sexual Minority Stress Model [IASMS]; i.e., the development, or lack, of strong socio-emotional bonds) and minority stress (i.e., social stress experienced by individuals in minority social groups) as a means to better understand and address the health needs of disadvantaged youth transitioning to adulthood. Dr. Cook and her team’s long-term goal is to continue creating, implementing, and refining sustainable interventions to reduce the influence of stress on health utilizing innovative methodologies.
Current Projects
- GeoSENSE: Geospatial Study on Intersectionality, Discrimination, and Cardiometabolic Health Behaviors Among Young Sexual and Gender Minorities
- Identifying Physiological and Behavioral Mechanisms Linking Discrimination and Subclinical Cardiovascular Disease among Racially Diverse Young Sexual Minority Men
- Minority Stress, Substance Use, and Pre-Clinical Cardiovascular Risk among Sexual Minority Men: Understanding the Protective Features of Social Support
- Optimizing a Daily Mindfulness Intervention to Reduce Stress from Discrimination among Sexual and Gender Minorities of Color
- Race modifies the association between post-traumatic stress disorder and cardiovascular risk in large US population-based study
Teaching
Social and Behavioral Sciences Department
- Global Issues in Social and Behavioral Health
- Research Methods in Public Health
Biostatistics Department
- Longitudinal Analysis of Public Health Data
- Regression I: Regression Analysis and Multivariate Modeling
- Regression II: Categorical Data Analysis
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Education
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BA, Psychology and Women’s Studies, University of Michigan, Ann Arbor, MIMPH, Sociomedical Sciences, Columbia University, New York, NYDrPH, Sociomedical Sciences, Columbia University, New York, NY
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Honors and awards
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National Institutes of Health (NIH) Summer Institute Fellowship on Randomized Behavioral Clinical Trials Fellowship (2023)New York University Faculty Fellow in Residence, New York University (2023)New York University James Weldon Johnson Professor (2023)NIH Loan Repayment Program Award, National Heart, Lung, and Blood Institute (2023)Outstanding Research Mentor, The Undergraduate Research Opportunity Program, The University of Michigan (2022)New York University Dr. Martin Luther King Jr. Faculty Award (2022)Loan Repayment Program, National Heart, Lung, and Blood Institute (2021)BioData Catalyst Fellowship, National Heart, Lung, and Blood Institute (NHLBI) (2021)Diverse Magazine Emerging Scholar: Issues In Higher Education Publication, (2021)Program to Increase Diversity in Cardiovascular Health Related Research (PRIDE) Fellowship (2020)American Psychosomatic Society (APS) Diversity Award (2020)National Institute of Minority Health Disparities Loan Repayment Award (2018)Inter-university Consortium for Political and Social Research (ICPSR) Summer Program in Quantitative Methods of Social Research Scholarship, The University of Michigan (2018)Robert Wood Johnson Fellow (RWJF) New Connections Sponsored Scholar (2018)HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI) Award (2017)Robert Wood Johnson Fellow (RWJF) New Connections Sponsored Scholar (2017)Matilda White Riley Distinguished Early Stage Investigator Award, National Institutes of Health (Office of Behavioral and Social Sciences) (2016)Outstanding Postdoctoral Fellow Award, The University of Michigan (2015)American Psychological Association Smoking Dissemination Award (2015)Poster Award, Excellence in Innovation and Advanced Research in the Field of Sexual Health, American Public Health Association (2014)Excellence in Abstract Submission, American Public Health Association (2011)
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Areas of research and study
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BiostatisticsCardiovascular DiseaseIntersectionality TheoryLongitudinal MethodsMinority HealthMinority StressMultiphase Optimization Strategy (MOST)Physiological StressSocial Behaviors
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Publications
Publications
Understanding Attachment Transitions Through the Lived Experiences of Young Black Gay and Bisexual Men
AbstractCook, S. H., Valera, P., Wood, E. P., Calebs, B. J., & Wilson, P. A. (n.d.).Publication year
2019Journal title
Journal of Sex ResearchVolume
56Issue
4Page(s)
604-619AbstractWe conducted a mixed-methods study to identify factors that influence transitions in attachment style between childhood and adulthood among 28 young Black gay and bisexual men (YBGBM) in the United States. We used a phenomenological approach to data integration, with the major component to the results being garnered from the qualitative interviews. We organized our results by four attachment transition groups: stable secure (secure attachment in childhood and young adulthood), stable insecure (insecure attachment in childhood and young adulthood), secure to insecure (secure in childhood and insecure in adulthood) and insecure to secure (insecure in childhood and secure in adulthood). Within each of the typologies, two major themes emerged: social support and religion. Generally, transitions from secure to insecure attachment were related to experiences of perceived rejection by a parental figure during adolescence that corresponded with sexual orientation disclosure. Transitions from insecure to secure attachment appeared to be related to the absence of an attachment figure early in life, but with the acquisition of an attachment figure during early to late adolescence. The findings from our study suggest a need for attachment-based approaches to social support interventions, as well as for an increased understanding of social and cultural factors that impact attachment changes among practitioners who use attachment-based therapy models for YBGBM.Are trajectories of a syndemic index in adolescence linked to HIV vulnerability in emerging and young adulthood?
AbstractCórdova, D., Heinze, J. E., Hsieh, H. F., Mistry, R., Salas-Wright, C. P., Cook, S. H., & Zimmerman, M. A. (n.d.).Publication year
2018Journal title
AIDSVolume
32Issue
4Page(s)
495-503AbstractObjectives: To examine trajectories of adolescent psychosocial risk-drug use, depressive and anxiety symptoms, and violence victimization and observation-and the longitudinal relationship between psychosocial risk trajectories during adolescence and HIV risk behaviors in adulthood. Methods: The 18-year longitudinal study was conducted from September 1994 through May 2013, in Michigan. Eight hundred and fifty predominantly (80%) African-American adolescents completed demographics and measures of drug use, depressive and anxiety symptoms, violence victimization and observation at Times 1-4, sexual risk behaviors at Times 5 and 6, and social conditions (i.e. family, peer, and community-level factors) between 14.9 and 32.0 years of age. Results: Growth mixture modeling revealed two trajectories of psychosocial risk factors which can be characterized as a syndemic index: high-frequency and low-frequency. The high-frequency class was more likely to report HIV risk behaviors, including condomless sex at last sexual intercourse with their primary and secondary partner, sexual intercourse with someone they just met, at least four sexual partners, and licit and illicit drug use prior to sexual intercourse at Time 5 (mean age 23.1). At Time 6 (mean age 32.0), the high-frequency class was more likely to report sexual intercourse with someone they just met and at least four sexual partners, relative to the low-frequency class. In addition, the high-frequency class was linked to peer and family-level indicators of social conditions. Conclusion: A syndemic index comprised of co-occurring psychosocial risk factors in adolescence seem to have lasting effects on the vulnerability to engage in HIV risk behaviors in emerging adulthood, some of which extend into young adulthood.Family conflict, chaos, and negative life events predict cortisol activity in low-income children
AbstractDoom, J. R., Cook, S. H., Sturza, J., Kaciroti, N., Gearhardt, A. N., Vazquez, D. M., Lumeng, J. C., & Miller, A. L. (n.d.).Publication year
2018Journal title
Developmental PsychobiologyVolume
60Issue
4Page(s)
364-379AbstractChildhood poverty is hypothesized to increase risk for mental and physical health problems at least in part through dysregulation of the hypothalamic-pituitary-adrenal axis. However, less is known about the specific psychosocial stressors associated with cortisol reactivity and regulation for children living in poverty. The current study investigates negative life events, household chaos, and family conflict in preschool and middle childhood as potential predictors of cortisol regulation in low-income 7–10 year olds (N = 242; M age = 7.9 years). Participants were assessed in preschool and participated in a follow-up assessment in middle childhood, during which diurnal free cortisol and free cortisol reactivity to the Trier Social Stress Test for Children (TSST-C) were assessed. Household chaos during preschool predicted a more blunted diurnal cortisol slope in middle childhood. Greater negative life events during preschool and greater concurrent family conflict were associated with increased free cortisol reactivity in middle childhood.Friendship Attachment Style Moderates the Effect of Adolescent Exposure to Violence on Emerging Adult Depression and Anxiety Trajectories
AbstractHeinze, J. E., Cook, S. H., Wood, E. P., Dumadag, A. C., & Zimmerman, M. A. (n.d.).Publication year
2018Journal title
Journal of Youth and AdolescenceVolume
47Issue
1Page(s)
177-193AbstractExposure to violence during adolescence is associated with increased risk behaviors and mental health problems in adulthood. Friendship attachment during adolescence may, however, mitigate the negative effects of exposure to violence on trajectories of depression and anxiety in young adulthood. In this study, we used growth curve modeling to examine associations between exposure to violence and mental health outcomes, followed by multi-group analyses with friendship attachment as the moderator. The sample was drawn from a longitudinal study (12 waves; 1994–2012) of 676 (54% female) urban high school students. We found strong positive associations between exposure to violence during adolescence and later self-reported depressive and anxiety symptoms. Notably, securely attached adolescents reported faster decreases in mental health symptoms as a function of violence relative to their insecurely attached peers as they transitioned into adulthood.Psychometric analysis of the life worries scale for a new generation of sexual minority men: The P18 cohort study
AbstractHalkitis, P. N., Cook, S. H., Ristuccia, A., Despotoulis, J., Levy, M. D., Bates, F. C., & Kapadia, F. (n.d.).Publication year
2018Journal title
Health PsychologyVolume
37Issue
1Page(s)
89-101AbstractObjective: Sexual minority men (SMM) in the United States continue to experience adverse health problems and psychosocial burdens. However, there is limited psychometric research seeking to quantify the life worries of this population. Informed by syndemic theory, the Life Worries Scale (LWS) was developed to measure the concerns of young SMM. Method: Analyses of the scale were undertaken using baseline data (n = 665) from an ongoing cohort study of emerging adult, SMM. Results: Exploratory factor analyses (EFA) of an initial set of 24 Likert-type items, followed by confirmatory factor analysis (CFA) and an exploratory structural equation model (ESEM), indicated a structure consisting of 6 domains of worries: financial stability, social stability, self esteem, loneliness, physical appearance, and physical health. These 6 subscales were highly correlated and also demonstrated high levels of internal consistency. Differences in life worries were noted across demographic states, specifically HIV serostatus, sexual attraction, housing status, and self-rated health. High levels of association were also detected between all 6 subscales with both depression and PTSD, while significant correlations were detected between suicidality and both self esteem and loneliness related worries. Conclusions: The results of our analyses provide evidence for the strong psychometric characteristics of the LWS. This newly developed instrument should be utilized in research to examine the extent to which life worries explain health outcomes and risk behaviors in sexual minority males, and may be potentially extended for use in other populations.Relationship cognitions and longitudinal trajectories of sexual risk behavior among young gay and bisexual men: The P18 cohort study
AbstractCook, S. H., Halkitis, P. N., & Kapadia, F. (n.d.).Publication year
2018Journal title
Journal of health psychologyVolume
23Issue
14Page(s)
1884-1894AbstractThis study examines how romantic relationship cognitions are associated with changes of condomless anal sex among emerging adult gay and bisexual men. The sample was drawn from four waves of a prospective cohort study (N = 598; M age = 18.2). Results suggest that condomless anal sex increased over the emerging adulthood period. Romantic relationship fear was associated with increased receptive condomless anal sex. Perceptions of greater romantic relationship control increased the likelihood of having insertive and receptive condomless anal sex. Findings suggest that romantic relationship cognitions are important to consider when understanding longitudinal changes in condomless anal sex in this population.Sexual orientation moderates the association between parental overprotection and stress biomarker profiles
AbstractCook, S. H., Pruessner, J. C., Lupien, S. J., & Juster, R. P. (n.d.).Publication year
2018Journal title
Psychology and SexualityVolume
9Issue
3Page(s)
204-220AbstractEarly experiences with parents may be particularly difficult for lesbian, gay and bisexual (LGB) individuals who face stigma that is linked to potentially distinct stress-related biobehavioural profiles. This study examined the association between parental bonding in relation to acute stress (cortisol reactivity) and chronic stress (allostatic load) in LGB and heterosexual individuals. The sample consisted of 87 healthy adults (mean [SD] age = 24.6 [0.6] years; LGB: n = 46, 43% women; and heterosexual n = 41, 49% women). Regressions tested the main effects of retrospectively assessed parental overprotection and care before the age of 16 on stress reactive cortisol (area under the curve) and allostatic load (indexed using 21 neuroendocrine, immune, metabolic and cardiovascular biomarkers), and whether sexual orientation status moderated this association. Results revealed that parental overprotection was associated with increased cortisol reactivity only for LGB participants, but not for heterosexual participants. By contrast, parental overprotection was associated with higher allostatic load only for heterosexual participants, but not for LGB participants. While the functional significance of this requires further study, these preliminary findings suggest that adaptive processes among LGB individuals may mitigate the negative effects of parental overprotection on markers of chronic stress.Stress levels are associated with poor sleep health among sexual minority men in Paris, France
AbstractMountcastle, H. D., Park, S. H., Al-Ajlouni, Y. A., Goedel, W. C., Cook, S., Lupien, S., Obasi, E. M., Hale, L., Jean-Louis, G., Redline, S., & Duncan, D. T. (n.d.).Publication year
2018Journal title
Sleep HealthVolume
4Issue
5Page(s)
436-441AbstractObjective: The objective of this study was to examine the association between perceived stress and sleep health among a sample of sexual minority men (SMM). Design: Cross-sectional survey. Setting: Paris, France. Participants: Gay, bisexual and other SMM users ≥18 years on a geosocial networking application in Paris, France (N = 580). Measurements: Participants were directed to a web-based survey measuring stress, sleep health, and socio-demographics. Multivariate log-binomial regression models were used to estimate the adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) to examine how stress may affect different dimensions of sleep health: 1) poor sleep quality, 2) short sleep duration, 3) problems falling asleep, and 4) problems staying awake in the daytime. Results: Most participants (69.9%) reported at least sometimes feeling stressed (compared to never or rarely). Additionally, results demonstrate that higher perceived stress was associated with poorer sleep health; compared with those who reported feeling stress never or rarely, those who felt stress sometimes, often, or always were more likely to experience poor sleep quality (aRR = 6.67; 95% CI = 3.61–12.3), short sleep duration (aRR = 1.67; 95% CI = 1.17–2.38), problems falling asleep (aRR = 3.20; 95% CI = 2.26–4.52), and problems staying awake during the daytime (aRR = 3.52; 95% CI = 1.64–7.53). Conclusion: Elevated perceived stress can negatively influence sleep health among SMM in Paris, France.Teacher-Based Racial Discrimination: The Role of Racial Pride and Religiosity Among African American and Caribbean Black Adolescents
AbstractButler-Barnes, S. T., Cook, S., Leath, S., & Caldwell, C. (n.d.).Publication year
2018Journal title
Race and Social ProblemsVolume
10Issue
1Page(s)
30-41AbstractThis study explored the extent to which private regard and religiosity beliefs serve as protective factors for school bonding among African American and Caribbean black adolescents who experience racial discrimination in school. Findings are drawn from a nationally representative sample of (n = 810) African American and (n = 360) Caribbean black adolescents (52% girls) aged 13–17 (Mage = 15, SD = 1.42) years. Results suggest that perceiving racial discrimination from teachers was associated with lower levels of school bonding for African American and Caribbean black adolescents. For African American adolescents, perceiving more racial discrimination from teachers and reporting lower private regard beliefs was associated with less school bonding. The findings for Caribbean black adolescents revealed that endorsing moderate levels of religiosity and perceiving higher rates of teacher discrimination was associated with less school bonding. The developmental significance and implications for future research are discussed.Adult attachment as a moderator of the association between childhood traumatic experiences and depression symptoms among young black gay and bisexual men
AbstractCook, S. H., Valera, P., Calebs, B. J., & Wilson, P. A. (n.d.).Publication year
2017Journal title
Cultural Diversity and Ethnic Minority PsychologyVolume
23Issue
3Page(s)
388-397AbstractThe present study examined the moderating effect of adult attachment on the association between childhood traumatic experiences, (i.e., physical abuse, emotional abuse, emotional neglect, and being bullied), age of childhood traumatic experience, and young adult depression symptoms among young Black gay and bisexual men (YBGBM). Method: Self-report measures of attachment, childhood traumatic experiences, and depression symptoms were collected from a community-based sample of YBGBM living in New York City (n = 228). Regression analyses were conducted to address the study goals. Results: Findings indicated that YBGBM who were more anxious in their adult attachment style and experienced being bullied or physically abused by a non-family member during childhood experienced greater depression in young adulthood than YBGBM who were less anxious in their adult attachment style. In addition, we found that being bullied later in childhood was associated with greater depression symptoms than being bullied earlier. Lastly, we found that YBGBM who were more avoidant and bullied later in adolescence reported more depression symptoms in young adulthood than YBGBM who were less avoidant in their attachment style. Discussion: The findings suggest that it may be important to utilize an attachment perspective that is sensitive to age of traumatic experience when creating mental health and trauma interventions for YBGBM.Cortisol profiles differ by race/ethnicity among young sexual minority men
AbstractCook, S. H., Juster, R. P., Calebs, B. J., Heinze, J., & Miller, A. L. (n.d.).Publication year
2017Journal title
PsychoneuroendocrinologyVolume
75Page(s)
1-4AbstractMuch of the extant scientific research examining hypothalamic-pituitary-adrenal (HPA)-axis functioning is conducted among White heterosexuals. Very little research examines HPA-axis functioning between different minority groups. Individuals who identify as both sexual and racial minorities may experience increased stigma and discrimination that can affect HPA-axis functioning. In the current study, we examined diurnal cortisol rhythm in young White gay men (WGM) compared to young Black gay men (BGM). The sample consisted of 70 healthy gay men (mean [SD] age = 22.9 [3.2]: 68% White and 38% Black) who collected four saliva samples daily for five days. Repeated measures analysis of covariance and post-hoc tests revealed that BGM had higher cortisol levels than WGM in the evening. Secondary analyses revealed no significant group differences for the cortisol awakening response or systemic output throughout the day. However, BGM compared to WGM had a lower drop from peak (morning) to lowest (evening) cortisol concentrations. Taken together, these findings reveal a flatter diurnal cortisol rhythm among BGM compared to WGB. The functional significance of these preliminary findings must be explored further with assessment of psychosocial factors among sexual minorities at the intersection of multiple identities. In summary, we expand health disparities research aimed at delineating sexual minority and race/ethnic variation in stress physiology.Minority males: Cultural stressors and their impact on health and well-being
Cook, S., Calebs, B., Perry, M., & Hopkins, R. (n.d.). In Social issues in living color: Challenges and solutions from the perspective of ethnic minority psychology (1–).Publication year
2017Attachment orientation and sexual risk behaviour among young Black gay and bisexual men
AbstractCook, S. H., Watkins, D. C., Calebs, B. J., & Wilson, P. A. (n.d.).Publication year
2016Journal title
Psychology and SexualityVolume
7Issue
3Page(s)
177-196AbstractThis mixed methods study used an explanatory sequential design to examine the relationship between attachment and sexual behaviour among young Black gay and bisexual men (YBGBM). Cross sectional online surveys and sex diaries were completed by a sample of YBGBM in New York City (n = 153) to assess the association between adult attachment insecurity and sexual risk behaviour. The Experiences in Close Relationships Scale-Revised (ECR-R) was used to assess three types of adult attachment (i.e., secure, anxious and avoidant). Participants reported condomless sex encounters, as well as serodiscordant condomless anal sex encounters, as measures of sexual risk. Quantitative findings suggested that there were few associations between attachment type and sexual risk behaviour; only men with attachment avoidance were likely to engage in condomless sex. However, qualitative findings illuminated some of the social complexities of the association between attachment in childhood, attachment in young adulthood and intimate partnerships, which could be linked to young adult sexual risk behaviour. The study findings highlight the need for researchers to further examine the process by which individual differences in attachment orientation are related to YBGBM’s sexual behaviour.Profiles of Resilience and Psychosocial Outcomes among Young Black Gay and Bisexual Men
AbstractWilson, P. A., Meyer, I. H., Antebi-Gruszka, N., Boone, M. R., Cook, S. H., & Cherenack, E. M. (n.d.).Publication year
2016Journal title
American journal of community psychologyVolume
57Issue
1Page(s)
144-157AbstractYoung Black gay/bisexual men (YBGBM) are affected by contextual stressors - namely syndemic conditions and minority stress - that threaten their health and well-being. Resilience is a process through which YBGBM achieve positive psychosocial outcomes in the face of adverse conditions. Self-efficacy, hardiness and adaptive coping, and social support may be important resilience factors for YBGBM. This study explores different profiles of these resilience factors in 228 YBGBM in New York City and compares profiles on psychological distress, mental health, and other psychosocial factors. Four profiles of resilience were identified: (a) Low self-efficacy and hardiness/adaptive coping (23.5%); (b) Low peer and parental support (21.2%); (c) High peer support, low father support (34.5%); and (d) High father and mother support, self-efficacy, and hardiness/adaptive coping (20.8%). YBGBM in profile 1 scored markedly higher on distress (d =.74) and lower on mental health functioning (d =.93) compared to men in the other profiles. Results suggest that self-efficacy and hardiness/adaptive coping may play a more important role in protecting YBGBM from risks compared to social support and should be targeted in interventions. The findings show that resilience is a multidimensional construct and support the notion that there are different patterns of resilience among YBGBM.Relationship cognitions and longitudinal trajectories of sexual risk behavior among young gay and bisexual men: The P18 cohort study
Cook, S., Halkitis, P. N., & Kapadia, F. (n.d.).Publication year
2016Journal title
Journal of Health PsychologySex Differences in Virtual Network Characteristics and Sexual Risk Behavior Among Emerging Adults
AbstractCook, S. H., Bauermeister, J. A., & Zimmerman, M. A. (n.d.).Publication year
2016Journal title
Emerging AdulthoodVolume
4Issue
4Page(s)
284-297AbstractEmerging adults (EAs) aged 18–24 account for a large proportion of all sexually transmitted infections (STIs), HIV infections, and unintended pregnancies in the United States. Given the increased influence of online media on decision making, we examined how EA online networks were associated with sexual risk behaviors. We used egocentric network data collected from EAs aged 18–24 years old across the United States (N = 1,687) to examine how online social norms (e.g., acceptance of HIV infections, other STIs, and pregnancy) and network characteristics (i.e., network size and density; ties’ closeness, race, age, and sex similarities) were associated with participants’ unprotected vaginal intercourse in the last 30 days. Findings suggested that in male EAs, there was a strong association between online social norms, structural characteristics, and sexual risk behavior compared to females. Researchers and practitioners may wish to address online peer norms and EAs’ online network composition when developing online sexual risk prevention tools.Sexual identity and HIV status influence the relationship between internalized stigma and psychological distress in black gay and bisexual men
AbstractBoone, M. R., Cook, S. H., & Wilson, P. A. (n.d.).Publication year
2016Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIVVolume
28Issue
6Page(s)
764-770AbstractExperiences of internalized homophobia and HIV stigma in young Black gay and bisexual men (GBM) may lead to psychological distress, but levels of distress may be dependent upon their sexual identity or HIV status. In this study, we set out to explore the associations between psychological distress, sexual identity, and HIV status in young Black GBM. Participants were 228 young Black GBM who reported on their psychological distress, their HIV status, and their sexual identity. Results indicated that internalized homophobia was significantly related to psychological distress for gay men, but not for bisexual men. HIV stigma was related to psychological stress for HIV-positive men, but not for HIV-negative men. Results indicate a need for more nuanced examinations of the role of identity in the health and well-being of men who have sex with men.The Integrated Attachment and Sexual Minority Stress Model: Understanding the Role of Adult Attachment in the Health and Well-Being of Sexual Minority Men
AbstractCook, S. H., & Calebs, B. J. (n.d.).Publication year
2016Journal title
Behavioral MedicineVolume
42Issue
3Page(s)
164-173AbstractGay and bisexual boys and men experience social stigma associated with their sexual minority status that can negatively influence health. In addition, experiencing sexual orientation stigma may be linked to a decreased capacity to effectively form and maintain secure attachment relationships with parents, peers, and romantic partners across the life-course. We proposed that utilizing a framework that integrates the process by which sexual minority men develop attachment relationships in the context of sexual minority stress can lead to a better understanding of health and well-being among sexual minority boys and men. In addition, we highlight where future research can expand upon the presented model in order to better understand the developmental processes through which attachment and sexual minority stress influences health and health behaviors among sexual minority boys and men.Transitions in Friendship Attachment during Adolescence are Associated with Developmental Trajectories of Depression Through Adulthood
AbstractCook, S. H., Heinze, J. E., Miller, A. L., & Zimmerman, M. A. (n.d.).Publication year
2016Journal title
Journal of Adolescent HealthVolume
58Issue
3Page(s)
260-266AbstractPurpose Forming secure friendship attachments during adolescence are important for mental health; few, however, have specifically examined the ways in which the transitions in attachment during adolescence may influence future mental health outcomes among African Americans. Methods The present study examines how transitions in attachment in adolescence predicted changes in depression symptoms from late adolescents through adulthood in an African-American sample. We used growth curve modeling to examine the association between transitions in friendship attachment and changes in depression symptoms in adulthood. Results At age 16 years, 346 (64.0%) adolescents reported secure attachment with 195 (36.0%) reporting either avoidant or resistant attachment. At age 17 years, 340 (62.9%) reported secure attachment and 201 (37.2%) reported avoidant or resistant attachment. The largest percentage of participants (46.2%) reported stable-secure attachment across the two time points. Results of the growth model indicated that adolescents who reported a stable-secure attachment style had lower levels of depression symptoms during adulthood than those individuals who transitioned from secure-to-insecure, from insecure-to-secure, or were in the stable-insecure group. Interestingly enough, individuals in both the attachment transition groups had a faster declining rate of depression symptoms over time compared to the two stability groups. Conclusions Data support existing research showing an association between transitions in attachment during adolescence and depression through adulthood. Furthermore, these study findings suggest there may be protective features associated with transitioning between attachment styles during adolescence on later depression, compared to African Americans who remain stable in their attachment style.HIV status disclosure, depressive symptoms, and sexual risk behavior among HIV-positive young men who have sex with men
AbstractCook, S. H., Valera, P., & Wilson, P. A. (n.d.).Publication year
2015Journal title
Journal of Behavioral MedicineVolume
38Issue
3Page(s)
507-517AbstractThe rate of HIV infection among young men who have sex with men (YMSM) is increasing in the United States, and targeted research is needed to inform interventions aimed at reducing HIV transmission in this population. This study aims to understand the association between HIV status disclosure and sexual risk behavior among HIV-positive YMSM. A particular focus is given to depressive symptoms and their potential role in explaining the association between HIV disclosure and sexual risk behavior. In a sample of 991 YMSM receiving care at 20 clinics across the United States, Univariate and multivariate analyses were conducted to explore these associations. Approximately one-half (52.4 %) of participants reported disclosing to their current sexual/romantic partner. Disclosure to family members was negatively associated with sexual risk behavior. Also, depressive symptoms were positively associated with sexual risk behavior. We discuss the implications of our findings for future research and intervention.The Smoking Behaviors and Cancer-Related Disparities Among Urban Middle Aged and Older Men Involved in the Criminal Justice System
AbstractValera, P., Anderson, M., Cook, S. H., Wylie-Rosett, J., Rucker, J., & Reid, A. E. (n.d.).Publication year
2015Journal title
Journal of Cancer EducationVolume
30Issue
1Page(s)
86-93AbstractThis study examined cancer knowledge, mental health, and tobacco use in formerly incarcerated men. The Cancer-Health Research Study with Formerly Incarcerated Men in New York City used a cross-sectional research design to examine cancer knowledge and prevention (CKP) outcomes among 259 justice-involved males, ages 35–67. CKP was assessed using items from the National Cancer Institute’s Health Information National Trends Survey. Psychological symptoms were examined using the Brief Symptom Inventory. Of the 259 men who completed the survey, 76 % of the respondents self-reported as current smokers. Current smokers smoked between 1 and 40 cigarettes per day. The mean number of cigarettes smoked per day was 10.37 (SD = 6.76). Sixty-five percent (n = 165) of the respondents underwent cancer-screening tests. CKP scores ranged from 2 to 28; the mean was 15.05 (SD = 5.49), indicating that the men scored very low in terms of CKP. CKP scores were negatively associated with the number of cigarettes smoked per day, τ = −.13, p =.01. These results have important implications for enhancing access to cancer-health education programs in justice-involved settings.What does attachment have to do with HIV transmission among young gay black and bisexual men?
Cook, S. (n.d.).Publication year
2015Journal title
The American Men's Studies Association Quarterly Newsletter"They are not taking cigarettes from me... I'm going to smoke my cigarettes until the day I die. I don't care if I get cancer": Smoking behaviors of men under community supervision in New York City
AbstractValera, P., Cook, S. H., Darout, R., & Dumont, D. M. (n.d.).Publication year
2014Journal title
Nicotine and Tobacco ResearchVolume
16Issue
6Page(s)
800-806AbstractIntroduction: Cigarette smoking declined from 42.4% in 1965 to 19.3% in 2010 among the general population, but it remains the leading cause of preventable death and illness in the United States, especially among high-risk populations, including those with criminal justice involvement. Methods: A mixed-methods approach was used to investigate the smoking behaviors of men under parole or probation. Phase I focused on qualitative data of 30 semi-structured interviews of men who were recently released from a state prison and/or jail. Phase II analyzed quantitative data resulting from a study that examined smoking characteristics and treatment approaches of 259 participants, 197 of whom were cigarette smokers. Results: The survey participants' age of tobacco initiation ranged from 7 to 45 years of age. Participants smoked between 1 and 40 cigarettes per day; the mean number of cigarettes smoked per day was 10.37. Men released from prison used cigarettes for more years on average than men released from jail (t[194] = -2.22, p < .05). A linear regression procedure revealed that the influence of friends and family significantly predicted smoking behavior (β = .25, p < .0001). The qualitative data revealed the following themes: unintended consequences of the prison smoking ban, smoking as anxiety management, smoking cigarettes as part of a daily routine, and barriers to quitting. Conclusions: Given the rapid growth of individuals under community supervision, public health and policy makers are missing an opportunity to develop strategies that promote smoking cessation treatments, especially among men who are serving parole or probation and during the incarceration period itself.Conducting Health Disparities Research with Criminal Justice Populations: Examining Research, Ethics, and Participation
AbstractValera, P., Cook, S., Macklin, R., & Chang, Y. (n.d.).Publication year
2014Journal title
Ethics and BehaviorVolume
24Issue
2Page(s)
164-174AbstractThis study explored the challenges of informed consent and understanding of the research process among Black and Latino men under community supervision (e.g., parole and/or probation). Between February and October 2012, we conducted cognitive face-to-face interviews using open-ended questions on the significant areas of research participation (i.e., the informed consent process, confidentiality, compensation, what is meant by human subject and clinical trials) among 259 men aged 35 to 67 under community supervision in Bronx, New York. Content analysis of the open-ended questions revealed limited knowledge concerning the understanding of research participation. The study participants appeared to generally understand concepts such as compensation after research participation and confidentiality. Participants demonstrated a lack of understanding of certain aspects of the research process-informed consent, human subject, Institutional Review Board, and clinical trials. These findings are informative to researchers conducting studies with criminal justice populations and Institutional Review Boards reviewing research studies.Understanding the role of mhealth and other media interventions for behavior change to enhance child survival and development in low-and middle-income countries: An evidence review
AbstractHiggs, E. S., Goldberg, A. B., Labrique, A. B., Cook, S. H., Schmid, C., Cole, C. F., & Obregón, R. A. (n.d.).Publication year
2014Journal title
Journal of Health CommunicationVolume
19Page(s)
164-189AbstractGiven the high morbidity and mortality among children in low-and middle-income countries as a result of preventable causes, the U.S. government and the United Nations Children's Fund convened an Evidence Summit on Enhancing Child Survival and Development in Lower-and Middle-Income Countries by Achieving Population-Level Behavior Change on June 3-4, 2013, in Washington, D.C. This article summarizes evidence for technological advances associated with population-level behavior changes necessary to advance child survival and healthy development in children under 5 years of age in low-and middle-income countries. After a rigorous evidence selection process, the authors assessed science, technology, and innovation papers that used mHealth, social/transmedia, multiplatform media, health literacy, and devices for behavior changes supporting child survival and development. Because of an insufficient number of studies on health literacy and devices that supported causal attribution of interventions to outcomes, the review focused on mHealth, social/transmedia, and multiplatform media. Overall, this review found that some mHealth interventions have sufficient evidence to make topic-specific recommendations for broader implementation, scaling, and next research steps (e.g., adherence to HIV/AIDS antiretroviral therapy, uptake and demand of maternal health service, and compliance with malaria treatment guidelines). While some media evidence demonstrates effectiveness in changing cognitive abilities, knowledge, and attitudes, evidence is minimal on behavioral endpoints linked to child survival. Population level behavior change is necessary to end preventable child deaths. Donors and low-and middle-income countries are encouraged to implement recommendations for informing practice, policy, and research decisions to fully maximize the impact potential of mHealth and multimedia for child survival and development.