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

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 is currently a scholar within 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 is partnering with Kaiser Permanente Washington health system leaders to address gaps in the quality of behavioral health care for children and adolescents. 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

Bobb JF, Lee AK, Lapham GT, Oliver M, Ludman E, Achtmeyer C, Parrish R, Caldeiro RM, Lozano P, Richards JE, Bradley KA. Evaluation of a pilot implementation to integrate alcohol-related care within primary care. Int J Environ Res Public Health. 2017 Sep 8;14(9). pii: E1030. doi: 10.3390/ijerph14091030. PubMed

Williams EC, Lapham GT, Rubinsky AD, Chavez LJ, Berger D, Bradley KA. Influence of a targeted performance measure for brief intervention on gender differences in receipt of brief intervention among patients with unhealthy alcohol use in the Veterans Health Administration. J Subst Abuse Treat. 2017;81:11-16. doi: 10.1016/j.jsat.2017.07.009. Epub 2017 Jul 19. PubMed

Takahashi T, Lapham G, Chavez LJ, Lee AK, Williams EC, Richards JE, Greenberg D, Rubinsky A, Berger D, Hawkins EJ, Merrill JO, Bradley KA. Comparison of DSM-IV and DSM-5 criteria for alcohol use disorders in VA primary care patients with frequent heavy drinking enrolled in a trial. Addict Sci Clin Pract. 2017;12(1):17. doi: 10.1186/s13722-017-0082-0. PubMed

Bradley KA, Ludman EJ, Chavez LJ, Bobb JF, Ruedebusch SJ, Achtmeyer CE, Merrill JO, Saxon AJ, Caldeiro RM, Greenberg DM, Lee AK, Richards JE, Thomas RM, Matson TE, Williams EC, Hawkins E, Lapham G, Kivlahan DR. Patient-centered primary care for adults at high risk for AUDs: the Choosing Healthier Drinking Options In primary CarE (CHOICE) trial. Addict Sci Clin Pract. 2017 May 17;12(1):15. doi: 10.1186/s13722-017-0080-2. PubMed

Williams EC, Lapham GT, Shortreed SM, Rubinsky AD, Bobb JF, Bensley KM, Catz SL, Richards JE, Bradley KA. Among patients with unhealthy alcohol use, those with HIV are less likely than those without to receive evidence-based alcohol-related care: a national VA study. Drug Alcohol Depend. 2017 May 1;174:113-120. doi: 10.1016/j.drugalcdep.2017.01.018. Epub 2017 Mar 6. PubMed

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

 

Electronic health records

Health conditoin risk in patients cannabis use, venn diagram, KP health form

EHR study offers insights on medical cannabis use

New research examines providers’ notes to understand patients’ cannabis use and health conditions.

catalyst

CATALYST-faculty-scholars_2col.jpg

Four CATALyST scholars selected to train as learning health system scientists

KP Washington, UW, WSU, and the VA join forces in a new research training program aimed at transforming health care.

Read it in News and Events.

Latest News

access-to-marijuana-1col.jpg

Kaiser Permanente researchers explore patients’ marijuana use

Routinely asking about cannabis use can better serve patients by helping clinicians start conversations about risks and benefits.

Read it in News and Events.

innovating care

Cara-Lewis-measurement-based-care-behavioral-health_1col.jpg

Let's put measurement-based care in behavioral health treatment

Dr. Cara Lewis reflects on using implementation science to integrate patient-reported symptoms into behavioral health care.

KPWHRI In the Media

Kaiser Permanente researchers explore patients’ marijuana use

Fertility: The problem with weed: For men, getting high may have unexpected consequences

Seattle Magazine, April 2018