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.

 ​​​

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

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

Lapham GT, Rubinsky AD, Heagerty PJ, Achtmeyer C, Williams EC, Hawkins EJ, Maynard C, Kivlahan DR, Au D, Bradley KA. Probability and predictors of patients converting from negative to positive screens for alcohol misuse. Alcohol Clin Exp Res. 2014 Feb;38(2):564-71. doi: 10.1111/acer.12260. Epub 2013 Oct 7. PubMed

Williams EC, Rubinsky AD, Lapham GT, Chavez LJ, Rittmueller SE, Hawkins EJ, Grossbard J, Kivlahan DR, Bradley KA. Prevalence of clinically recognized alcohol and other substance use disorders among VA outpatients with unhealthy alcohol use identified by routine alcohol screening. Alcohol Drug Depend. 2014 Feb 1;135:95-103. doi: 10.1016/j.drugalcdep.2013.11.016. Epub 2013 Nov 27. PubMed

Delaney KE, Lee A, Lapham GT, Rubinsky AD, Chavez LJ, Bradley KA. Inconsistencies between alcohol screening results based on AUDIT-C scores and reported drinking on the AUDIT-C questions: prevalence in two national samples. Addict Sci Clin Pract. 2014 Jan 27;9(1):2. doi: 10.1186/1940-0640-9-2. PubMed

Lapham GT, Rubinsky AD, Heagerty PJ, Williams EC, Hawkins EJ, Maynard C, Kivlahan DK, Bradley KA. Annual rescreening for alcohol misuse: diminishing returns for some patient subgroups. Med Care. 2013 Oct;51(10):914-21. doi: 10.1097/MLR.0b013e3182a3e549. PubMed

Bradley KA, Chavez LJ, Lapham GT, Williams EC, Achtmeyer CE, Rubinsky AD,Hawkins EJ, Saitz R, Kivlahan DR. When quality measures undermine quality: bias in a quality measure for follow-up for alcohol misuse. Psychiatr Serv. 2013 Oct;64(10):1018-25. doi: 10.1176/appi.ps.201200449. Epub 2013 Jul 15. 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