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
Recent publications
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
Chavez LJ, Bradley KA, Lapham GT, Wickizer TM, Chisolm DJ. Identifying problematic substance use in a national sample of adolescents using frequency questions. J Am Board Fam Med. 2019;32(4):550-558. doi: 10.3122/jabfm.2019.04.180284. PubMed
Research
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
What's new in cannabis use research?
Use in pregnancy and screening in primary care studied by KPWHRI’s Kiel, Matson, and Lapham.
New findings
Research roundup on natural language processing and machine learning
Using doctor's notes to learn about drug reactions, dementia, and cannabis use.
New findings
Patient-centered perspectives on teen mental health
Annie Hoopes, MD, MPH, shares insights from an ACT Center study on integrating adolescent mental health in primary care.
KPWHRI In the Media
Gwen Lapham on documentation of medical cannabis use in electronic health records
Medical cannabis use often left undocumented in electronic health records
Mediquality/Reuters Health, June 11, 2022
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