Gwen Lapham, PhD, MPH
"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
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Behavior Change
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Addictions & Unhealthy Substance Use
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Health Services & Economics
Implementation research; quality measurement
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Implementation Research
Screening and brief intervention; mental health quality measurement
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Child & Adolescent Health
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Addictions
Prevention and treatment
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
Berger D, Lapham GT, Shortreed SM, Hawkins EJ, Rubinsky AD, Williams EC, Achtmeyer CE, Kivlahan DR, Bradley KA. Increased rates of documented alcohol counseling in primary care: more counseling or just more documentation? J Gen Intern Med. 2018 Mar;33(3):268-274. doi: 10.1007/s11606-017-4163-2. Epub 2017 Oct 18. PubMed
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
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Increasing opioid use disorder treatment in primary care
A trial led by KPWHRI researchers found that adding nurse care managers helped more people get needed treatment.
Research
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.
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
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