Stephanie Cook

Associate Professor of Social and Behavioral Sciences

Associate Professor of Biostatistics

Professional overview

Dr. Stephanie Cook's research focuses on understanding the complex relationship between stress, health, and social determinants of health across the lifespan. Her work examines how both structural and individual-level stressors contribute to mental and physical health outcomes, particularly in vulnerable populations. Dr. Cook is particularly interested in how features of close relationships—such as attachment patterns—can either exacerbate or buffer the negative effects of stress on overall well-being.

Her current research explores how daily and momentary experiences of stress are linked to physical health markers (e.g., cortisol, C-reactive protein) and health behaviors (e.g., substance use, sexual risk behaviors). She focuses on how these stressors impact health trajectories over time, particularly among young adults navigating significant life transitions.

Dr. Cook employs advanced longitudinal study designs, including intensive longitudinal methods, to track how changes in stress exposure affect changes in risk behaviors and physical health outcomes.

As the Director of the Attachment and Health Disparities Research Lab (AHDL), Dr. Cook leads a team of undergraduates, graduate students, and postdoctoral fellows in exploring innovative ways to mitigate the impact of stress on health. She has developed an integrated model combining adult attachment theory and stress research to better understand how relational factors influence health outcomes for individuals facing social disadvantage. Her long-term goal is to develop and implement sustainable interventions aimed at reducing the harmful effects of stress on health, with a focus on improving health equity.

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

Education

BA, Psychology and Women’s Studies, University of Michigan, Ann Arbor, MI

MPH, Sociomedical Sciences, Columbia University, New York, NY

DrPH, Sociomedical Sciences, Columbia University, New York, NY

Honors and awards

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)

Areas of research and study

Biostatistics

Cardiovascular Disease

Intersectionality Theory

Longitudinal Methods

Minority Health

Minority Stress

Multiphase Optimization Strategy (MOST)

Physiological Stress

Social Behaviors

Publications

Publications

What does attachment have to do with HIV transmission among young gay black and bisexual men?

Cook, S. (n.d.).

Publication year

2015

Journal 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

Valera, P., Cook, S. H., Darout, R., & Dumont, D. M. (n.d.).

Publication year

2014

Journal title

Nicotine and Tobacco Research

Volume

16

Issue

6

Page(s)

800-806

10.1093/ntr/ntt280

Abstract

Abstract

Introduction: 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

Valera, P., Cook, S., Macklin, R., & Chang, Y. (n.d.).

Publication year

2014

Journal title

Ethics and Behavior

Volume

24

Issue

2

Page(s)

164-174

10.1080/10508422.2013.826581

Abstract

Abstract

This 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

Higgs, E. S., Goldberg, A. B., Labrique, A. B., Cook, S. H., Schmid, C., Cole, C. F., & Obregón, R. A. (n.d.).

Publication year

2014

Journal title

Journal of Health Communication

Volume

19

Page(s)

164-189

10.1080/10810730.2014.929763

Abstract

Abstract

Given 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.

Exploring the relationship between gender nonconformity and mental health among black South African gay and bisexual men

Cook, S. H., Sandfort, T. G., Nel, J. A., & Rich, E. P. (n.d.). In Archives of Sexual Behavior (1–).

Publication year

2013

Volume

42

Issue

3

Page(s)

327-330

10.1007/s10508-013-0087-z

Online Network Influences on Emerging Adults' Alcohol and Drug Use

Cook, S. H., Bauermeister, J. A., Gordon-Messer, D., & Zimmerman, M. A. (n.d.).

Publication year

2013

Journal title

Journal of Youth and Adolescence

Volume

42

Issue

11

Page(s)

1674-1686

10.1007/s10964-012-9869-1

Abstract

Abstract

Researchers have reported that network characteristics are associated with substance use behavior. Considering that social interactions within online networks are increasingly common, we examined the relationship between online network characteristics and substance use in a sample of emerging adults (ages 18-24) from across the United States (N = 2,153; M = 21 years old; 47 % female; 70 % White). We used regression analyses to examine the relationship between online ego network characteristics (i.e., characteristics of individuals directly related to the focal participant plus the relationships shared among individuals within the online network) and alcohol use and substance use, respectively. Alcohol use was associated with network density (i.e., interconnectedness between individuals in a network), total number of peer ties, and a greater proportion of emotionally close ties. In sex-stratified models, density was related to alcohol use for males but not females. Drug use was associated with an increased number of peer ties, and the increased proportion of network members' discussion and acceptance of drug use, respectively. We also found that online network density and total numbers of ties were associated with more personal drug use for males but not females. Conversely, we noted that social norms were related to increased drug use and this relationship was stronger for females than males. We discuss the implications of our findings for substance use and online network research.

Participation in research involving novel sampling and study designs to identify acute HIV-1 infection among minority men who have sex with men.

Rodriguez, K., Castor, D., Mah, T. L., Cook, S. H., Auguiste, L. M., Halkitis, P. N., & Markowitz, M. (n.d.).

Publication year

2013

Journal title

Unknown Journal

Volume

25

Issue

7

Page(s)

828-834

10.1080/09540121.2012.748164

Abstract

Abstract

HIV-1 infection disproportionally affects African-American and Latino men who have sex with men (MSM). Their inclusion in biomedical and behavioral research is critical to understanding and addressing HIV vulnerability. Using focus groups, we sought to understand the perceptions related to participating in biomedical research of acute/recent HIV-1 infection (AHI) using complex sampling and data collection methods to reach this hidden group at highest risk of acquiring and transmitting HIV. Given the potential impact of AHI on HIV transmission in MSM, it is important to understand this intersection for HIV prevention, care, and treatment purposes. The aim of this study was to understand how recruitment and data collection methods affect AHI research participation willingness particularly among MSM of color. Findings suggest that major barriers to research participation with complex sampling to identify AHI and intensive risk behavior collection such as diary methods are lack of anonymity, partner disclosure, and study fatigue. The authors explore implications for future study designs and development based on these findings.

Substance use and sexual risk behavior in HIV-positive men who have sex with men: An episode-level analysis

Boone, M. R., Cook, S. H., & Wilson, P. (n.d.).

Publication year

2013

Journal title

AIDS and Behavior

Volume

17

Issue

5

Page(s)

1883-1887

10.1007/s10461-012-0167-4

Abstract

Abstract

Men who have sex with men (MSM) make up nearly half of all people living with HIV in the United States. The prevalence of the epidemic in this population makes it vitally important to understand the transmission of the infection and to develop methods to prevent its spread. The current study uses longitudinal diary methods to examine relationships between substance use and unprotected anal intercourse in a sample of 158 HIV-positive, mostly ethnic minority MSM. Results indicate that both general substance use and use of specific drugs (i.e., inhalants, cocaine, crack, and club drugs) have a substantial impact on the sexual risk behavior of this population.

Deficits in dopamine D 2 receptors and presynaptic dopamine in heroin dependence: Commonalities and differences with other types of addiction

Martinez, D., Saccone, P. A., Liu, F., Slifstein, M., Orlowska, D., Grassetti, A., Cook, S., Broft, A., Van Heertum, R., & Comer, S. D. (n.d.).

Publication year

2012

Journal title

Biological Psychiatry

Volume

71

Issue

3

Page(s)

192-198

10.1016/j.biopsych.2011.08.024

Abstract

Abstract

Positron emission tomography (PET) imaging studies have shown that addiction to a number of substances of abuse is associated with a decrease in dopamine D 2/3 receptor binding and decreased presynaptic dopamine release in the striatum. Some studies have also shown that these reductions are associated with the severity of addiction. For example, in cocaine dependence, low dopamine release is associated with the choice to self-administer cocaine. The goal of the present study was to investigate these parameters of striatal dopamine transmission in heroin dependence and their association with drug seeking behavior. Heroin-dependent and healthy control subjects were scanned with [ 11C]raclopride before and after stimulant administration (methylphenidate) to measure striatal D 2/3 receptor binding and presynaptic dopamine release. After the PET scans, the heroin-dependent subjects performed heroin self-administration sessions. Both striatal D 2/3 receptor binding and dopamine release were reduced in the heroin-dependent subjects compared with healthy control subjects. However, neither PET measure of dopamine transmission predicted the choice to self-administer heroin. These findings show that heroin addiction, like addiction to other drugs of abuse, is associated with low D 2/3 receptor binding and low presynaptic dopamine. However, neither of these outcome measures was associated with the choice to self-administer heroin.

Intimate-partner violence and HIV in South African women

Castor, D., Cook, S., Leclerc-Madlala, S., & Shelton, J. (n.d.). In The Lancet (1–).

Publication year

2010

Volume

376

Issue

9748

Page(s)

1219

10.1016/S0140-6736(10)61870-3

Situational predictors of sexual risk episodes among men with HIV who have sex with men

Wilson, P. A., Cook, S., McGaskey, J., Rowe, M., & Dennis, N. (n.d.).

Publication year

2008

Journal title

Sexually transmitted infections

Volume

84

Issue

6

Page(s)

506-508

10.1136/sti.2008.031583

Abstract

Abstract

Background: Men with HIV who have sex with men (MSM) represent the largest group of people living with HIV/AIDS in the United States. It is important to understand the sexual risk-taking behaviours that may be linked to the transmission of HIV and other sexually transmitted infections in this population. Models of HIV risk that focus solely on personal factors have been demonstrated to be ineffective at explaining risk behaviour. Rather, in order to fully understand sexual risktaking, it is important to examine the factors linked to high-risk sexual situations and not solely the factors linked to potentially high-risk people. Methods: A diverse sample of 100 MSM with HIV completed a 6-week internet-based sex diary that collected detailed information on recent sexual encounters. In total, information on over 250 sexual episodes was collected and analysed. Generalised linear mixed models were used to examine situational predictors of risk episodes. Results: Analyses revealed that drug use by self and sex partners (examined individually and together) were positively related to risk episodes. Likewise, having a sex partner met online and having a sexual encounter in a sex party or bathhouse setting was linked to risk episodes. Sexual episodes that involved a sex-partner who was perceived as sexually desirable and those involving communication about HIV and/or condom use with partners each were negatively related to risk. Conclusions: Situational factors play an important role in explaining sexual risk-taking among MSM with HIV. Researchers should place a greater focus on drug use and characteristics of sex partners and settings in which sexual behaviours occur as situational predictors of risk in order to comprehensively understand sexual risk-taking in this population.