Dr. Bradley is an expert in design and evaluation of patient-centered, evidence- based care for alcohol misuse in medical settings. She is an Investigator at Group Health Research Institute (GHRI) and Affiliate Professor of Medicine and Health Services at University of Washington. She is also an Associate Investigator at Veterans Affairs (VA) Puget Sound Health Care System. She has conducted groundbreaking research aimed at implementation of evidence-based care for risky drinking and alcohol use disorders (AUDs) in primary care. Her achievements include validation of the 3-item AUDIT-C in VA and non- VA populations and collaboration with clinical and quality leaders in the VA to implement alcohol screening and brief interventions (BIs) in over 900 VA sites nationwide. She has now expanded her focus to include management of AUDs in primary care. Dr. Bradley's currently funded studies aimed at improving alcohol- related primary care include: the CHOICE trial of nurse-delivered collaborative care for AUDs (NIAAA R01); a pragmatic trial of implementation of alcohol screening and BIs, and shared decision-making for AUDs, in 25 primary care clinics (AHRQ R18); and a study to develop a decision aid to support shared decision-making between primary care providers and their patients with AUDs (NIAAA R21). MENTORING EXPERIENCE and PLANNED MENTORING: Dr. Bradley is an outstanding mentor who has successfully mentored 28 early career clinician investigators. The proposed K24 will allow her to recruit and mentor 10-15 early-stage clinician researchers committed to patient-centered alcohol-related implementation research during the 5-year award. CAREER DEVELOPMENT: The proposed career award will support Dr. Bradley in achieving 3 career objectives: 1) to remain at the forefront of alcohol-related implementation research in medical settings; 2) to develop new expertise for implementing and evaluating eHealth interventions for AUDs-online and mobile health programs-in primary care; and 3) to mentor the next generation of innovators in alcohol-related research in medical settings. RESEARCH: New eHealth interventions for AUDs are being developed at a rapid rate and might especially benefit primary care patients with AUDs who are unwilling to enter treatment. However, the effectiveness of eHealth AUD programs in primary care is untested.
Aim 1 will be to design a strategy for implementing one eHealth AUD program--online cognitive behavioral therapy (CBT)-in primary care.
Aim 2 will be to evaluate the implementation strategy for online CBT that we design in Aim 1. This research will support Dr. Bradley and her mentees' training, as well as pave the way for pragmatic trials of eHealth AUD programs in primary care. IMPACT. The proposed career award will allow Dr. Bradley to mentor the next generation of leaders in innovative alcohol-related implementation research in medical settings, while expanding her research program to evaluate the effectiveness of eHealth programs for AUDs in primary care.

Public Health Relevance

Dr. Bradley is a recognized expert in research on management of alcohol misuse in medical settings, and an outstanding mentor. She is conducting cutting-edge implementation research, introducing alcohol screening and brief alcohol intervention in primary care and testing new models of primary care for alcohol use disorders based on shared decision-making. The proposed K24 will allow her to mentor promising early stage clinician investigators while conducting innovative research aimed at understanding how to use evidence-based eHealth programs to support primary care physicians and patients in managing alcohol use disorders.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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National Institute on Alcohol Abuse and Alcoholism Initial Review Group (AA)
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Kwako, Laura Elizabeth
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Kaiser Foundation Research Institute
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Williams, Emily C; Achtmeyer, Carol E; Young, Jessica P et al. (2018) Barriers to and Facilitators of Alcohol Use Disorder Pharmacotherapy in Primary Care: A Qualitative Study in Five VA Clinics. J Gen Intern Med 33:258-267
Williams, Emily C; Bryson, Chris L; Sun, Haili et al. (2018) Association Between Alcohol Use and Angina Symptoms Among Outpatients From the Veterans Health Administration. J Addict Med 12:143-149
Williams, Emily C; McGinnis, Kathleen A; Bobb, Jennifer F et al. (2018) Changes in alcohol use associated with changes in HIV disease severity over time: A national longitudinal study in the Veterans Aging Cohort. Drug Alcohol Depend 189:21-29
Bradley, Katharine A; Bobb, Jennifer F; Ludman, Evette J et al. (2018) Alcohol-Related Nurse Care Management in Primary Care: A Randomized Clinical Trial. JAMA Intern Med 178:613-621
Berger, Douglas; Lapham, Gwen T; Shortreed, Susan M et al. (2018) Increased Rates of Documented Alcohol Counseling in Primary Care: More Counseling or Just More Documentation? J Gen Intern Med 33:268-274
Glass, Joseph E; Bobb, Jennifer F; Lee, Amy K et al. (2018) Study protocol: a cluster-randomized trial implementing Sustained Patient-centered Alcohol-related Care (SPARC trial). Implement Sci 13:108
Williams, Emily C; McGinnis, Kathleen A; Edelman, E Jennifer et al. (2018) Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare. AIDS Behav :
Bradley, Katharine; Williams, Emily C (2018) Necessary Clarifications Concerning Results of the SUMMIT Trial. JAMA Intern Med 178:428-429
Lapham, Gwen T; Lee, Amy K; Caldeiro, Ryan M et al. (2018) Prevalence of Behavioral Health Conditions Across Frequency of Cannabis Use Among Adult Primary Care Patients in Washington State. J Gen Intern Med 33:1833-1835
Takahashi, Traci; Lapham, Gwen; Chavez, Laura J et al. (2017) 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 12:17

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