Gwen Lapham, PhD, MPH

Gwen Lapham

"My research focuses on primary care, currently in two areas: understanding cannabis use and integration of mental health services for adolescents."

Gwen Lapham, PhD, MPH, MSW

Assistant Investigator, Kaiser Permanente Washington Health Research Institute
Assistant Professor, Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine

Gwen.T.Lapham@kp.org
206-287-2021

Biography

Gwen Lapham, PhD, MPH, MSW, joined Kaiser Permanente Washington Health Research Institute (KPWHRI) in 2013 as an addictions health services researcher. Since then, she has capitalized on her prior social work and health services training to do impactful research on evidence-based primary care for unhealthy substance use, including alcohol, cannabis, and opioids. She has recently begun making strides in understanding cannabis use among primary care patients, including medical use and use among prenatal women.

Dr. Lapham recently completed the CATALyST K12 Washington Learning Health System Program funded by the Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute. In the program, she partnered with Kaiser Permanente Washington health system leaders and with KPWHRI’s Center for Accelerating Care Transformation to address gaps in the quality of behavioral health care for children and adolescents by developing and testing an integrated approach to adolescent mental health. She expects this work to lead to new evidence for effective implementation of adolescent mental health integrated in primary care.

She is also a co-investigator of the Primary Care Opioid Use Disorders Treatment, or PROUD trial, a pragmatic implementation trial of nurse care management for treatment of opioid use disorders in primary care, as well as the Health Systems node of the National Institute on Drug Abuse Clinical Trials Network. Dr. Lapham’s research projects specific to cannabis include:

  • A pilot study about the prevalence of and reasons for cannabis use among pregnant women. This study uses both cannabis screening results from the electronic health record (EHR) and qualitative interviews.
  • Site principal investigator for a multisite study that examined patient-level and system-level factors associated with the Healthcare Effectiveness Data and Information Set, commonly known as HEDIS, to measure performance for initiation and engagement in treatment for patients with cannabis use disorders.
  • Co-principal investigator for a study evaluating EHR documentation of medical use of cannabis. This study employs natural language processing methods to compare EHR data with data from confidential surveys about medical cannabis use.

Prior to working at KPWHRI, Dr. Lapham focused on qualitative and quantitative evaluation of preventive alcohol interventions in medical settings at the Veterans Health Administration in Seattle.

RESEARCH INTERESTS AND EXPERIENCE

  • Behavior Change

  • Addictions & Unhealthy Substance Use

  • Health Services & Economics

    Implementation research; quality measurement

  • Implementation Research

    Screening and brief intervention; mental health quality measurement


Sparc trial tools

Resources for behavioral health integration

The SPARC trial successfully implemented behavioral health care into primary care. On our website, you can access tools for behavioral health integration, as well as frequently asked questions and publications.


Recent publications

Bradley KA, Rubinsky AD, Lapham GT, Berger D, Bryson C, Achtmeyer C, Hawkins EJ, Chavez LJ, Williams EC, Kivlahan DR. Predictive validity of clinical AUDIT-C alcohol screening scores and changes in scores for three objective alcohol-related outcomes in a Veterans Affairs (VA) population. Addiction. 2016 Nov;111(11):1975-1984. doi: 10.1111/add.13505. Epub 2016 Aug 2. PubMed

Grossbard J, Malte CA, Lapham G, Pagulayan K, Turner AP, Rubinsky AD, Bradley KA, Saxon AJ, Hawkins EJ. Prevalence of alcohol misuse and follow-up care in a national sample of OEF/OIF VA patients with and without TBI. Psychiatr Serv. 2017 Jan 1;68(1):48-55. doi: 10.1176/appi.ps.201500290. Epub 2016 Aug 1. PubMed

Chavez LJ, Williams EC, Lapham GT, Rubinsky AD, Kivlahan DR, Bradley KA. Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.  J Stud Alcohol Drugs. 2016 May;77(3):500-8. PubMed

Bradley KA, Lapham GT. Is it time for a more ambitious research agenda for decreasing alcohol-related harm among young adults? Addiction. 2016 Sep;111(9):1531-2. doi: 10.1111/add.13235. Epub 2016 Mar 6. PubMed

Williams EC, Achtmeyer CE, Young JP, Rittmueller SE, Ludman EJ, Lapham GT, Lee AK, Chavez LJ, Berger D, Bradley KA. Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: perspectives of clinical and administrative staff. J Subst Abuse Treat. 2015 Jul 26. J Subst Abuse Treat. 2016 Jan;60:27-35. doi: 10.1016/j.jsat.2015.07.011. Epub 2015 Jul 26. PubMed

Chavez LJ, Liu CF, Tefft N, Herbert PL, Clark BJ, Rubinsky AD, Lapham GT, Bradley KA. Unhealthy alcohol use in older adults: association with readmissions and emergency department use in the 30 days after hospital discharge. Drug Alcohol Depend. 2016 Jan 1;158:94-101. doi: 10.1016/j.drugalcdep.2015.11.008. Epub 2015 Nov 19.

Ornelas IJ, Lapham GT, Salgado H, Williams EC, Gotman N, Womack V, Davis S, Penedo F, Smoller S, Gallo LC. Binge drinking and perceived ethnic discrimination among Hispanics/Latinos: results from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. J Ethn Subst Abuse. 2016 Jul-Sep;15(3):223-239. Epub 2015 Dec 7. PubMed

Williams EC, Achtmeyer CE, Thomas RM, Grossbard JR, Lapham GT, Chavez LJ, Ludman EJ, Berger D, Bradley KA. Factors underlying quality problems with alcohol screening prompted by a clinical reminder in primary care: a multi-site qualitative study.  J Gen Intern Med. 2015 Aug;30(8):1125-32. doi: 10.1007/s11606-015-3248-z. Epub 2015 Mar 3. PubMed

Lapham GT, Rubinsky AD, Williams EC, Hawkins EJ, Grossbard J, Chavez LJ, Kivlahan DR, Bradley KA. Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics. Drug Alcohol Depend. 2014 Sep 1;142:209-15. doi: 10.1016/j.drugalcdep.2014.06.017. Epub 2014 Jun 23. PubMed

Williams EC, Rubinsky AD, Chavez LJ, Lapham GT, Rittmueller SE, Achtmeyer CE, Bradley KA. An early evaluation of implementation of brief intervention for unhealthy alcohol use in the U.S. Veterans Health Administration. Addiction. 2014 Sep;109(9):1472-81. doi: 10.1111/add.12600. Epub 2014 Jun 12. PubMed

 

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