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.

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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

Recent publications

McClure EA, Hamilton L, Schauer GL, Matson TE, Lapham GT. Cannabis and nicotine co-use among primary care patients in a state with legal cannabis access. Addict Behav. 2023;140:107621. doi: 10.1016/j.addbeh.2023.107621. Epub 2023 Jan 20. PubMed

Matson TE, Hallgren KA, Lapham GT, Oliver M, Wang X, Williams EC, Bradley KA. Psychometric performance of a substance use symptom checklist to help clinicians assess substance use disorder in primary care. JAMA Netw Open. 2023;6(5):e2316283. doi: 10.1001/jamanetworkopen.2023.16283. PubMed

Lee AK, Bobb JF, Richards JE, Achtmeyer CE, Ludman E, Oliver M, Caldeiro RM, Parrish R, Lozano PM, Lapham GT, Williams EC, Glass JE, Bradley KA. Integrating alcohol-related prevention and treatment into primary care: A cluster randomized implementation trial. JAMA Intern Med. 2023 Apr 1;183(4):e227083. doi: 10.1001/jamainternmed.2022.7083. PubMed

Kiel L, Hsu C, Wartko PD, Albertson-Junkans L, Ewing J, Lapham GT. Perspectives from women who engaged in prenatal and postpartum cannabis use in a U.S. State with legal non-medical use. Prev Med Rep. 2022 Nov 29;31:102075. doi: 10.1016/j.pmedr.2022.102075. eCollection 2023. PubMed

Matson TE, Lapham GT, Bobb JF, Oliver M, Hallgren KA, Williams EC, Bradley KA. Validity of the Single-Item Screen-Cannabis (SIS-C) for cannabis use disorder screening in routine care. JAMA Netw Open. 2022 Nov 1;5(11):e2239772. doi: 10.1001/jamanetworkopen.2022.39772. PubMed

Coley RY, Duan KI, Hoopes AJ, Lapham GT, Liljenquist K, Marcotte LM, Ramirez M, Schuttner L. A call to integrate health equity into learning health system research training. Learn Health Syst. 2022 Jul 24;6(4):e10330. doi: 10.1002/lrh2.10330. eCollection 2022. PubMed

Hoopes AJ, Brandzel SD, Luce C, Ferguson DM, Shulman L, Chavez B, Lozano P, Lapham GT. What do adolescents and their parents need from mental health integration in primary care? A qualitative exploration of design insights. J Pediatr Health Care. 2022 Aug 8:S0891-5245(22)00174-2. doi: 10.1016/j.pedhc.2022.06.006. [Epub ahead of print]. PubMed

Braciszewski JM, Idu AE, Yarborough BJH, Stumbo SP, Bobb JF, Bradley KA, Rossom RC, Murphy MT, Binswanger IA, Campbell CI, Glass JE, Matson TE, Lapham GT, Loree AM, Barbosa-Leiker C, Hatch MA, Tsui JI, Arnsten JH, Stotts A, Horigian V, Hutcheson R, Bart G, Saxon AJ, Thakral M, Ling Grant D, Pflugeisen CM, Usaga I, Madziwa LT, Silva A, Boudreau DM. Sex differences in comorbid mental and substance use disorders among primary care patients with opioid use disorder. Psychiatr Serv. 2022 Jun 16:appips202100665. doi: 10.1176/appi.ps.202100665. Online ahead of print. PubMed

Lapham GT, Matson TE, Carrell DS, Bobb JF, Luce C, Oliver MM, Ghitza UE, Hsu C, Browne KC, Binswanger IA, Campbell CI, Saxon AJ, Vandrey R, Schauer GL, Pacula RL, Horberg MA, Bailey SR, McClure EA, Bradley KA. Comparison of medical cannabis use reported on a confidential survey vs documented in the electronic health record among primary care patients. JAMA Netw Open. 2022 May 2;5(5):e2211677. doi: 10.1001/jamanetworkopen.2022.11677. PubMed

Carrell DS, Cronkite DJ, Shea M, Oliver M, Luce C, Matson TE, Bobb JF, Hsu C, Binswanger IA, Browne KC, Saxon AJ, McCormack J, Jelstrom E, Ghitza UE, Campbell CI, Bradley KA, Lapham GT. Clinical documentation of patient-reported medical cannabis use in primary care: toward scalable extraction using natural language processing methods. Subst Abus. 2022;43(1):917-924. doi: 10.1080/08897077.2021.1986767. PubMed

 

Research

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Is medical use of cannabis as risky as nonmedical use?

New findings indicate medical cannabis use is associated with a lower risk of moderate to severe cannabis use disorder.

New findings

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Better tools for assessing substance use disorder

A simple checklist developed at KPWHRI does well at measuring symptoms of substance use disorder.

Research

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Better care for patients who drink alcohol

A new primary care approach improves alcohol-related preventive care as well as care for alcohol use disorder.

Research roundup

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What's new in cannabis use research?

Use in pregnancy and screening in primary care studied by KPWHRI’s Kiel, Matson, and Lapham.

KPWHRI in the media

Frequency of cannabis use disorder in a state with legal use

Cannabis use disorder is common in one state where marijuana is legal

CNN, Aug. 29, 2023