Bonnie Halpern-Felsher Research Group

The Halpern-Felsher lab studies developmental, cognitive, psychosocial and cultural/social factors involved in adolescents’ and young adults’ health-related decision-making, perceptions of risk and vulnerability, health communication and risk behavior. Our work particularly focuses on understanding and reducing adolescent and young adult substance use (including tobacco, electronic cigarettes, alcohol, and marijuana), risky sexual behavior, and risky driving. Our research uses a number of methodological approaches, including large-scale research projects, studies involving longitudinal data, online data collection methods, mixed qualitative and quantitative data, interview and focus group data, and survey data. We also develop, implement and evaluate interventions, including pre-post tests and randomized control trials. Our research spans several age groups, including children, adolescents, young adults and parents.

Current Research Projects

The Role of Risk and Benefit Perceptions in Tobacco Control and Product Usage

Tobacco companies (including e-cigarette/vape companies) have developed and implemented advertising and marketing efforts to reduce perceptions of harm associated with tobacco use, increase perceptions that tobacco is socially acceptable, and ultimately encourage and sustain use of tobacco. These marketing strategies have particularly focused on changing perceptions and increasing tobacco use among adolescents and young adults. There are gaps in the science concerning:

How perceptions influence tobacco use among adolescents and young adults, including changes in patterns of tobacco use from initiation to regular use, cessation, relapse, product switching, or dual/poly use
The role of pro- and anti-tobacco messages on perceptions of new tobacco products such as e-cigarettes, small cigars (little cigars and cigarillos), smokeless tobacco, snus, dissolvables, compressed tobacco, and emerging products that come on the market during the course of this research
The specific mechanisms by which marketing messages change tobacco-related perceptions, perceived acceptability of the product, and tobacco use behaviors

Prospective, longitudinal studies using frequent assessments and comprehensive measures of tobacco use, perceptions, and marketing are needed in order to provide specific scientific evidence about how marketing shapes decisions to use and stop using different tobacco products. This information will inform FDA regulation of the marketing and promotion of conventional, new and emerging tobacco products. This study fills gap in the science base by developing and testing a novel, comprehensive model concerning the relationships among pro- and anti-tobacco marketing messages, perceptions of tobacco risks and benefits, perceived product acceptability, and patterns of tobacco use among adolescents and young adults. Using a longitudinal cohort design with a sample of adolescents followed for five years, the aims of this study are to:

Determine adolescents’ and young adults’ perceptions of risk for disease, addiction, and death; acceptability; and benefits of using conventional, new, and emerging tobacco products that come on the market during the course of this research
Determine the predictive relationships among perceptions of tobacco-related risks, benefits, and acceptability of tobacco products, and the onset, continuation, cessation, relapse, switching, and dual use of tobacco products
Identify contextual factors (exposure to pro-tobacco media, anti-tobacco media, warning labels, and smoking images in the media and on the Internet) that influence perceptions of risks, benefits, acceptability, and subsequent tobacco use.

This project is funded by Research by grant number 1P50CA180890 from the National Cancer Institute and Food and Drug Administration Center for Tobacco Products.

A Youth Development & Parent Toolkit for Tobacco Education, Stanford University

School-based tobacco education efforts have had mixed results, with some showing short- and long-term success in reducing tobacco usage, and other programs yielding little or no positive outcomes. Few tobacco prevention programs are developed by first directly asking the stakeholders of these programs (educators, students, and parents) what is missing from school-based tobacco prevention programs, and then incorporating these missing aspects into new prevention messages and delivery strategies.

Applying results from a previous Pilot SARA in which we identified missing health messages, the specific aims of our project are as follows:

To develop, test, and implement a toolkit containing a set of youth development modules applied to school-based tobacco control and education efforts. Specifically, we are developing (a) a module for tobacco educators on the principles of youth development, (b) modules for implementing youth development strategies and best practices in the schools, including one on best practices to encourage youth involvement, using peers and near-peers, guiding youth to develop anti-tobacco messages, and guiding youth to create media an advocacy campaigns, and (c) a module that includes tobacco (nicotine) addiction messages to increase understanding and appreciation of nicotine addiction in order to reduce initiation and encourage cessation among youth who discount the addictive nature of tobacco.
Develop a module focusing on reducing electronic cigarette use, and
Develop, test and implement modules for parents, aimed at providing information about school tobacco policies, school tobacco control efforts and messages that parents can use to reinforce and append school messages.

This project is funded by grant numbers 21HT-0002 and 23GT-0010 from the Tobacco-Related Disease Research Program (TRDRP) and the California Department of Education (CDE), Agreement No. CN120401.

Click here to view the Tobacco Prevention Toolkit Website

Assessing Determinants of Marijuana and Tobacco Use among High-Risk Adolescents: A Community Based Research Project between Stanford University and Key Stakeholders Working with Adolescents at the Santa Clara County Juvenile Hall

Research suggests that 51% of youth in detention centers have used marijuana at least once, and 16% use daily. Tobacco use is also high in this population, with studies showing that 67.5% of adolescent detainees use tobacco, a rate much higher than the national average of 17.2%.Despite the high rates of tobacco and marijuana use among youth in detention center settings, there are few studies that provide information about the unique factors influencing use and co-use of tobacco and marijuana among these high-risk youth. Further, there is little information regarding whether and how such information should be incorporated into interventions that can be implemented within juvenile detention centers, nor is there information regarding what contextual factors specific to the juvenile detention center should be taken into account when considering a clinical intervention in this setting.

The goal of this project is to gather formative information about unique factors contributing to marijuana and tobacco use among high-risk youth. Additionally, this project is a first step in assessing the possible role that the juvenile hall could and should play in addressing tobacco and marijuana use. Ultimately, it is expected that the results from this project will lead to effective programs to reduce tobacco and marijuana use among detained youth. This work is supported by the Stanford Clinical and Translational Science Award (CTSA) to Spectrum (UL1TR001085).

Step-Up High School Summer Science Program

National Institute of Diabetes and Digestive and Kidney Diseases (NIH/NIDDK) Short-term Research Experience for Underrepresented Persons (STEP-UP)

Purpose of the NIDDK STEP-UP Program:
To expose underrepresented minority and disadvantaged high school students (rising seniors or those heading to college) to research in the NIDDK mission areas including diabetes, endocrinology, metabolism, nutrition, obesity, and digestive, liver, urologic, kidney, and hematologic diseases. In addition to these mission areas, other areas of research are also welcome.

Overall Goal of STEP-UP:
To increase the number of underrepresented minority and disadvantaged students “in the pipeline” who are committed to a career in biomedical, behavioral, clinical, or social science research.

Summer Experience:
Step-Up students work with mentors (professors, postdoctoral fellows, medical or graduate students, or research assistants) to develop a hands-on summer project. The project not only enhances the student’s knowledge and skills in a particular area of scientific interest, but also enhances both their overall research capabilities and interest in pursuing a research career.

Requirements:

Student participants are required to work full-time (40 hours per week) for a minimum of 8 weeks.
Student begin the program in mid-June, provided they have completed their spring classes.
The summer session ends with the Annual STEP-UP High School Scientific Session and Summer Research Presentations, usually held the second week of August. This is at the National Institutes of Health in Bethesda, Maryland. All expenses are paid by the program.
Students are required to prepare an abstract and podium presentation (in PowerPoint format) of their summer research. Senior students will also prepare a poster. Funds are available through the program for poster preparation. Students will receive specific details for preparing their items for submission at a later date.
Students and mentors receive a stipend.

For more information, please click here.

Lab Members

Bonnie Halpern-Felsher, PhD, FSAHM

Dr. Halpern-Felsher is a Professor of Pediatrics. She is also the Director of Research and Associate Director of the Fellowship Program in Adolescent Medicine, Department of Pediatrics. Dr. Halpern-Felsher is a developmental psychologist whose research has focused on cognitive, psychosocial and environmental factors involved in adolescents’ and young adults’ health-related decision-making, perceptions of risk and vulnerability, health communication, and risk behavior. Her research has focused on understanding and reducing health risk behaviors such as tobacco use, alcohol and marijuana use, risky driving, and risky sexual behavior. Dr. Halpern-Felsher’s research and committee work have been instrumental in setting policy at the local, state, and national level. In California, Dr. Halpern-Felsher’s research was cited in support of school-based tobacco education initiatives within California’s Tobacco Education Research Oversight Committee’s 2012 Masterplan. This Masterplan sets funding priority areas for research, education and intervention for California. Dr. Halpern-Felsher is also collaborating with the California Department of Education to develop, implement and evaluate new school-based tobacco prevention and education materials. At the national level, Dr. Halpern-Felsher’s research was highlighted in the 2012 Surgeon General Report, ”Preventing Tobacco Use among Youth and Young Adults,” and Dr. Halpern-Felsher contributed to the chapter on Clinical interventions: The role of health care providers in the prevention of youth tobacco use. Dr. Halpern-Felsher has been a member of five Institute of Medicine, National Academies of Sciences committees focusing on adolescent and young adult health and risk behavior. She has served on the Board of Directors of the Society for Adolescent Health and Medicine (SAHM) and on Council for the Society for Pediatric Research (SPR). She currently Co-Chairs the SPR Mentoring Committee and Chairs the SAHM Taskforce on Parents and Youth. Dr. Halpern-Felsher was instrumental in getting SRA and SAHM to form partnerships to create a more comprehensive research agenda focusing on adolescent health.

David Cash, BA

Sheila McLaughlin, MFA

Sheila McLaughlin, MFA, is a Project Coordinator in the Division of Adolescent Medicine, Department of Pediatrics, Stanford University. Ms. McLaughlin holds firm to her commitment to assist youth during their high school years to achieve their educational and career goals. Ms. McLaughlin currently is the Project Coordinator for the “National Institute of Diabetes and Digestive and Kidney Diseases (NIH/NIDDK) Short-term Research Experience for Underrepresented Persons (STEP-UP),” where she gives force to her commitment to youth by facilitating each Step-Up student throughout their internship and by maintaining ongoing relationships among both mentors and alums. Concurrently, Ms. McLaughlin is the Project Coordinator of the “Role of Risk and Benefit Perceptions in Tobacco Control and Product Usage project,” a longitudinal study of adolescent tobacco use. She is responsible for the coordination, tracking and retention of over seven hundred research subjects and has worked with the Program Director to insure project goals are met.

Karma McKelvey, PhD, MPH

Karma McKelvey, PhD, MPH is a postdoctoral fellow at the Center for Tobacco Control Research and Education at the University of California San Francisco, collaborating with Dr. Halpern-Felsher on a number of projects. As an epidemiologist, Dr. McKelvey has a strong background in study design and a thorough understanding of the challenges inherent in implementing programming designed to improve population health. Dr. McKelvey’s goal is to lower rates of substance use initiation among children and youth by working in implementation science, defined as: “…the study of methods to promote the integration of research findings and evidence into healthcare policy and practice.” Her work includes conceptualizing, developing, implementing and evaluating (both process and outcome) behavioral interventions designed to improve communication skills, increase self-efficacy, and instill adaptive coping skills. These interventions could then be adapted for diverse populations and settings. Dr. McKelvey also has experience working with adolescents as a recovery coach, which included supporting youth through numerous challenges and helping them overcome varied circumstances common to children and families suffering from addiction(s) and substance use disorder. This work, coupled with her public health and epidemiologic training and experience, renders her uniquely qualified to continue to help improve the health and quality of life of future generations through work with the children of today.

Adrienne Lazaro, BS

Adrienne is a health educator, having worked both for the University of California, Davis, and, more recently, for a Federally Qualified Health Center in the Bay Area. In her role as a health educator at a school-based health center, Adrienne has worked to empower youth to make healthier decisions around issues such as pregnancy prevention; sexually transmitted infection prevention; alcohol, tobacco, and other drug use reduction; and healthy relationship building through one-on-one health counseling as well as through youth development programs. Adrienne is also a fellow in the Stanford Health 4 All post-baccalaureate certificate program, a program out of the Stanford Prevention Research Center that focuses on prevention of chronic diseases. She is interning in the lab, helping to develop the Tobacco Prevention Toolkit. She is ultimately interested in serving youth from marginalized communities in the Bay Area, through the development and implementation of evidence-based health interventions.