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CDA 12-276 – HSR&D Study

 
CDA 12-276
Implementation Research for Evidence-based Care for Alcohol Dependence
Emily C. Williams PhD MPH
VA Puget Sound Health Care System Seattle Division, Seattle, WA
Seattle, WA
Funding Period: October 2013 - September 2018

BACKGROUND/RATIONALE:
Alcohol use disorders (AUD) are common and chronic, affecting 6.5% of VA patients. While standard care is to refer patients with AUD to specialty addictions treatment, most do not go. Experts agree that care for AUD should be expanded to primary care settings. While many behavioral treatments that are offered in specialty settings cannot reasonably be delivered in primary care, three medications are FDA-approved for treating AUD, can be prescribed in primary care, and are recommended by VA guidelines. However, most Veterans with AUD (~95%) do not receive them, and there are likely many barriers to primary care providers' prescribing them. This CDA focused on addressing this gap in care for Veterans with AUD.

OBJECTIVE(S):
The specific aims were to: 1) Describe barriers and facilitators to VA primary care providers' treating AUD; 2) Develop and pre-test an intervention to prepare primary care providers to treat AUD in VA primary care; and 3) Test whether the intervention - disseminated in the context of other systems level supports for management of AUD - is effective for increasing prescriptions for AUD medications at a single VA facility.

METHODS:
Planned methods included using 1:1 qualitative interviews (Aims 1 and 2), focus groups (Aim 2), electronic surveys (Aims 2 and 3), and advanced interrupted time series design (Aim 3) applied to secondary VA clinical and administrative data and developing the intervention based on state-of-the-art social marketing methods and other behavior change theories.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
Dr. Williams's CDA research resulted in greater understanding of: 1) barriers to provision of pharmacotherapy for AUD in primary care and specialty clinics, 2) disparities in receipt of high-quality care for AUD and HIV across key patient- and community-level characteristics, and 3) patterns of alcohol use and care among transgender Veterans. Further, two implementation interventions are being developed and tested to increase access to care for addictive disorders for key populations of Veterans at risk. This research addresses key HSR&D priority areas (e.g., opioid use), is aligned with the Office of Equity and the Whole Health Initiative, and ultimately holds enormous potential to increase access to and quality of care, as well as health outcomes, for the substantial number of Veterans with substance use disorders.


External Links for this Project

NIH Reporter

Grant Number: IK2HX001161-01A1
Link: https://reporter.nih.gov/project-details/8596229

Dimensions for VA

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PUBLICATIONS:

Journal Articles

  1. Owens MD, Kirouac M, Hagler K, Rowell LN, Williams EC. "Being able to speak": What individuals in jail perceived as helpful about participating in alcohol-related brief interventions. Substance Abuse. 2017 Dec 5; 39(3):342-347. [view]
  2. Bertholet N, Daeppen JB, Studer J, Williams EC, Cunningham JA, Gmel G, Burnand B. A randomized trial of brief web-based prevention of unhealthy alcohol use: Participant self-selection compared to a male young adult source population. Internet interventions. 2020 Mar 1; 19:100298. [view]
  3. Edelman EJ, Williams EC, Marshall BDL. Addressing unhealthy alcohol use among people living with HIV: recent advances and research directions. Current opinion in infectious diseases. 2018 Feb 1; 31(1):1-7. [view]
  4. Katon JG, Lehavot K, Simpson TL, Williams EC, Barnett SB, Grossbard JR, Schure MB, Gray KE, Reiber GE. Adverse Childhood Experiences, Military Service, and Adult Health. American journal of preventive medicine. 2015 Oct 1; 49(4):573-82. [view]
  5. Eyawo O, McGinnis KA, Justice AC, Fiellin DA, Hahn JA, Williams EC, Gordon AJ, Marshall BDL, Kraemer KL, Crystal S, Gaither JR, Edelman EJ, Bryant KJ, Tate JP, VACS Project team. Alcohol and Mortality: Combining Self-Reported (AUDIT-C) and Biomarker Detected (PEth) Alcohol Measures Among HIV Infected and Uninfected. Journal of acquired immune deficiency syndromes (1999). 2018 Feb 1; 77(2):135-143. [view]
  6. Simpson TL, Rillamas-Sun E, Lehavot K, Timko C, Rubin A, Cucciare MA, Williams EC, Padula CB, Hunt JR, Hoggatt KJ. Alcohol Consumption Levels and All-Cause Mortality Among Women Veterans and Non-Veterans Enrolled in the Women's Health Initiative. The Gerontologist. 2016 Feb 1; 56 Suppl 1:S138-49. [view]
  7. Bachrach RL, Blosnich JR, Williams EC. Alcohol screening and brief intervention in a representative sample of veterans receiving primary care services. Journal of substance abuse treatment. 2018 Dec 1; 95:18-25. [view]
  8. Williams EC, McGinnis KA, Rubinsky AD, Matson TE, Bobb JF, Lapham GT, Edelman EJ, Satre DD, Catz SL, Richards JE, Bryant KJ, Marshall BDL, Kraemer KL, Crystal S, Gordon AJ, Skanderson M, Fiellin DA, Justice AC, Bradley KA. Alcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence?. AIDS and behavior. 2021 Jan 1; 25(1):203-214. [view]
  9. Tsui JI, Williams EC, Green PK, Berry K, Su F, Ioannou GN. Alcohol use and hepatitis C virus treatment outcomes among patients receiving direct antiviral agents. Drug and Alcohol Dependence. 2016 Dec 1; 169:101-109. [view]
  10. Williams EC, Hahn JA, Saitz R, Bryant K, Lira MC, Samet JH. Alcohol Use and Human Immunodeficiency Virus (HIV) Infection: Current Knowledge, Implications, and Future Directions. Alcoholism, clinical and experimental research. 2016 Oct 1; 40(10):2056-2072. [view]
  11. Kim NJ, Pearson M, Vutien P, Su F, Moon AM, Berry K, Green PK, Williams EC, Ioannou GN. Alcohol Use and Long-Term Outcomes Among U.S. Veterans Who Received Direct-Acting Antivirals for Hepatitis C Treatment. Hepatology communications. 2020 Feb 1; 4(2):314-324. [view]
  12. Lehavot K, Blosnich JR, Glass JE, Williams EC. Alcohol use and receipt of alcohol screening and brief intervention in a representative sample of sexual minority and heterosexual adults receiving health care. Drug and Alcohol Dependence. 2017 Oct 1; 179:240-246. [view]
  13. Chen JA, Owens MD, Browne KC, Williams EC. Alcohol-related and mental health care for patients with unhealthy alcohol use and posttraumatic stress disorder in a National Veterans Affairs cohort. Journal of substance abuse treatment. 2018 Feb 1; 85:1-9. [view]
  14. Bradley KA, Bobb JF, Ludman EJ, Chavez LJ, Saxon AJ, Merrill JO, Williams EC, Hawkins EJ, Caldeiro RM, Achtmeyer CE, Greenberg DM, Lapham GT, Richards JE, Lee AK, Kivlahan DR. Alcohol-Related Nurse Care Management in Primary Care: A Randomized Clinical Trial. JAMA internal medicine. 2018 May 1; 178(5):613-621. [view]
  15. 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 and Alcohol Dependence. 2017 May 1; 174:113-120. [view]
  16. Williams EC, Bryson CL, Sun H, Au DH, Bradley KA. Association Between Alcohol Use and Angina Symptoms Among Outpatients From the Veterans Health Administration. Journal of addiction medicine. 2018 Mar 1; 12(2):143-149. [view]
  17. Simonetti JA, Lapham GT, Williams EC. Association Between Receipt of Brief Alcohol Intervention and Quality of Care among Veteran Outpatients with Unhealthy Alcohol Use. Journal of general internal medicine. 2015 Aug 1; 30(8):1097-104. [view]
  18. Williams EC, Achtmeyer CE, Young JP, Berger D, Curran G, Bradley KA, Richards J, Siegel MB, Ludman EJ, Lapham GT, Forehand M, Harris AHS. Barriers to and Facilitators of Alcohol Use Disorder Pharmacotherapy in Primary Care: A Qualitative Study in Five VA Clinics. Journal of general internal medicine. 2018 Mar 1; 33(3):258-267. [view]
  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. Journal of ethnicity in substance abuse. 2016 Jul 1; 15(3):223-239. [view]
  20. Williams EC, McGinnis KA, Bobb JF, Rubinsky AD, Lapham GT, Skanderson M, Catz SL, Bensley KM, Richards JE, Bryant KJ, Edelman EJ, Satre DD, Marshall BDL, Kraemer KL, Blosnich JR, Crystal S, Gordon AJ, Fiellin DA, Justice AC, Bradley KA. Changes in alcohol use associated with changes in HIV disease severity over time: A national longitudinal study in the Veterans Aging Cohort. Drug and Alcohol Dependence. 2018 Aug 1; 189:21-29. [view]
  21. Satre DD, Sarovar V, Leyden W, Hare CB, Catz SL, Bryant KJ, Williams EC, Hojilla JC, Horberg MA, Silverberg MJ. Changes in Days of Unhealthy Alcohol Use and Antiretroviral Therapy Adherence, HIV RNA Levels, and Condomless Sex: A Secondary Analysis of Clinical Trial Data. AIDS and behavior. 2020 Jun 1; 24(6):1784-1792. [view]
  22. 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. Journal of studies on alcohol and drugs. 2016 May 1; 77(3):500-8. [view]
  23. 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. Addiction science & clinical practice. 2017 Jul 18; 12(1):17. [view]
  24. Blosnich JR, Lehavot K, Glass JE, Williams EC. Differences in Alcohol Use and Alcohol-Related Health Care Among Transgender and Nontransgender Adults: Findings From the 2014 Behavioral Risk Factor Surveillance System. Journal of studies on alcohol and drugs. 2017 Nov 1; 78(6):861-866. [view]
  25. Young JP, Achtmeyer CE, Bensley KM, Hawkins EJ, Williams EC. Differences in Perceptions of and Practices Regarding Treatment of Alcohol Use Disorders Among VA Primary Care Providers in Urban and Rural Clinics. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association. 2018 Sep 1; 34(4):359-368. [view]
  26. Bensley KM, Fortney J, Chan G, Dombrowski JC, Ornelas I, Rubinsky AD, Lapham GT, Glass JE, Williams EC. Differences in Receipt of Alcohol-Related Care Across Rurality Among VA Patients Living With HIV With Unhealthy Alcohol Use. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association. 2019 Jun 1; 35(3):341-353. [view]
  27. Frost MC, Glass JE, Bradley KA, Williams EC. Documented brief intervention associated with reduced linkage to specialty addictions treatment in a national sample of VA patients with unhealthy alcohol use with and without alcohol use disorders. Addiction (Abingdon, England). 2020 Apr 1; 115(4):668-678. [view]
  28. Williams EC, Lapham GT, Bobb JF, Rubinsky AD, Catz SL, Shortreed SM, Bensley KM, Bradley KA. Documented brief intervention not associated with resolution of unhealthy alcohol use one year later among VA patients living with HIV. Journal of substance abuse treatment. 2017 Jul 1; 78:8-14. [view]
  29. Williams EC, Bobb JF, Lee AK, Ludman EJ, Richards JE, Hawkins EJ, Merrill JO, Saxon AJ, Lapham GT, Matson TE, Chavez LJ, Caldeiro R, Greenberg DM, Kivlahan DR, Bradley KA. Effect of a Care Management Intervention on 12-Month Drinking Outcomes Among Patients With and Without DSM-IV Alcohol Dependence at Baseline. Journal of general internal medicine. 2019 Dec 10. [view]
  30. Lipira L, Williams EC, Hutcheson R, Katz AB. Evaluating the Impact of the Affordable Care Act on HIV Care, Outcomes, Prevention, and Disparities: A Critical Research Agenda. Journal of health care for the poor and underserved. 2017 Jan 1; 28(4):1254-1275. [view]
  31. 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. Journal of general internal medicine. 2015 Aug 1; 30(8):1125-32. [view]
  32. Park S, Chan KC, Williams EC. Gain of employment and perceived health status among previously unemployed persons: evidence from a longitudinal study in the United States. Public Health. 2016 Apr 1; 133:83-90. [view]
  33. Matson TE, McGinnis KA, Rubinsky AD, Frost MC, Czarnogorski M, Bryant KJ, Edelman EJ, Satre DD, Catz SL, Bensley KM, Fiellin DA, Justice AC, Williams EC. Gender and alcohol use: influences on HIV care continuum in a national cohort of patients with HIV. AIDS (London, England). 2018 Sep 24; 32(15):2247-2253. [view]
  34. Hill CM, Williams EC, Ornelas IJ. Help Wanted: Mental Health and Social Stressors Among Latino Day Laborers. American Journal of Men's Health. 2019 Mar 1; 13(2):1557988319838424. [view]
  35. Williams EC, McGinnis KA, Tate JP, Matson TE, Rubinsky AD, Bobb JF, Lapham GT, Edelman EJ, Catz SL, Satre DD, Bryant KJ, Marshall BDL, Kraemer KL, Bensley KM, Richards JE, Skanderson M, Justice AC, Fiellin DA, Bradley KA. HIV Disease Severity Is Sensitive to Temporal Changes in Alcohol Use: A National Study of VA Patients With HIV. Journal of acquired immune deficiency syndromes (1999). 2019 Aug 1; 81(4):448-455. [view]
  36. Lipira L, Williams EC, Huh D, Kemp CG, Nevin PE, Greene P, Unger JM, Heagerty P, French AL, Cohn SE, Turan JM, Mugavero MJ, Simoni JM, Andrasik MP, Rao D. HIV-Related Stigma and Viral Suppression Among African-American Women: Exploring the Mediating Roles of Depression and ART Nonadherence. AIDS and behavior. 2019 Aug 1; 23(8):2025-2036. [view]
  37. Richards JE, Hohl SD, Whiteside U, Ludman EJ, Grossman DC, Simon GE, Shortreed SM, Lee AK, Parrish R, Shea M, Caldeiro RM, Penfold RB, Williams EC. If You Listen, I Will Talk: the Experience of Being Asked About Suicidality During Routine Primary Care. Journal of general internal medicine. 2019 Oct 1; 34(10):2075-2082. [view]
  38. Edelman EJ, Hansen NB, Cutter CJ, Danton C, Fiellin LE, O'Connor PG, Williams EC, Maisto SA, Bryant KJ, Fiellin DA. Implementation of integrated stepped care for unhealthy alcohol use in HIV clinics. Addiction science & clinical practice. 2016 Jan 13; 11(1):1. [view]
  39. 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?. Journal of general internal medicine. 2018 Mar 1; 33(3):268-274. [view]
  40. 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. Journal of substance abuse treatment. 2017 Oct 1; 81:11-16. [view]
  41. Frost MC, Matson TE, Tsui JI, Williams EC. Influence of comorbid drug use disorder on receipt of evidence-based treatment for alcohol use disorder among VA patients with alcohol use disorder and Hepatitis C and/or HIV. Drug and Alcohol Dependence. 2019 Jan 1; 194:288-295. [view]
  42. Richards JE, Bobb JF, Lee AK, Lapham GT, Williams EC, Glass JE, Ludman EJ, Achtmeyer C, Caldeiro RM, Oliver M, Bradley KA. Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care: An evaluation in three pilot sites. Drug and Alcohol Dependence. 2019 Aug 1; 201:134-141. [view]
  43. Frost MC, Williams EC, Kingston S, Banta-Green CJ. Interest in Getting Help to Reduce or Stop Substance Use Among Syringe Exchange Clients Who Use Opioids. Journal of addiction medicine. 2018 Nov 1; 12(6):428-434. [view]
  44. Glass JE, Rathouz PJ, Gattis M, Joo YS, Nelson JC, Williams EC. Intersections of poverty, race/ethnicity, and sex: alcohol consumption and adverse outcomes in the United States. Social psychiatry and psychiatric epidemiology. 2017 May 1; 52(5):515-524. [view]
  45. Williams EC, McGinnis KA, Edelman EJ, Matson TE, Gordon AJ, Marshall BDL, Bryant KJ, Rubinsky AD, Lapham GT, Satre DD, Richards JE, Catz SL, Fiellin DA, Justice AC, Bradley KA. Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare. AIDS and behavior. 2019 Jan 1; 23(1):140-151. [view]
  46. 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. Journal of substance abuse treatment. 2016 Jan 1; 60:27-35. [view]
  47. Seelig AD, Bensley KM, Williams EC, Armenta RF, Rivera AC, Peterson AV, Jacobson IG, Littman AJ, Maynard C, Bricker JB, Rull RP, Boyko EJ, Millennium Cohort Study Team. Longitudinal Examination of the Influence of Individual Posttraumatic Stress Disorder Symptoms and Clusters of Symptoms on the Initiation of Cigarette Smoking. Journal of addiction medicine. 2018 Sep 1; 12(5):363-372. [view]
  48. Jacobson IG, Williams EC, Seelig AD, Littman AJ, Maynard CC, Bricker JB, Rull RP, Boyko EJ, Millennium Cohort Study Team. Longitudinal Investigation of Military-specific Factors Associated With Continued Unhealthy Alcohol Use Among a Large US Military Cohort. Journal of addiction medicine. 2020 Jul 1; 14(4):e53-e63. [view]
  49. Hoggatt KJ, Williams EC, Der-Martirosian C, Yano EM, Washington DL. National prevalence and correlates of alcohol misuse in women veterans. Journal of substance abuse treatment. 2015 May 1; 52:10-6. [view]
  50. 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. Addiction science & clinical practice. 2017 May 17; 12(1):15. [view]
  51. Bensley KM, McGinnis KA, Fortney J, Chan KCG, Dombrowski JC, Ornelas I, Edelman EJ, Goulet JL, Satre DD, Justice AC, Fiellin DA, Williams EC. Patterns of Alcohol Use Among Patients Living With HIV in Urban, Large Rural, and Small Rural Areas. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association. 2019 Jun 1; 35(3):330-340. [view]
  52. Lipira L, Rao D, Nevin PE, Kemp CG, Cohn SE, Turan JM, Simoni JM, Andrasik MP, French AL, Unger JM, Heagerty P, Williams EC. Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV. Drug and Alcohol Dependence. 2020 Jan 1; 206:107753. [view]
  53. Seelig AD, Rivera AC, Powell TM, Williams EC, Peterson AV, Littman AJ, Maynard C, Street AE, Bricker JB, Boyko EJ. Patterns of Smoking and Unhealthy Alcohol Use Following Sexual Trauma Among U.S. Service Members. Journal of traumatic stress. 2017 Oct 1; 30(5):502-511. [view]
  54. Bensley KM, Seelig AD, Armenta RF, Rivera AC, Peterson AV, Jacobson IG, Littman AJ, Maynard C, Bricker JB, Boyko EJ, Rull RP, Williams EC. Posttraumatic Stress Disorder Symptom Association With Subsequent Risky and Problem Drinking Initiation. Journal of addiction medicine. 2018 Sep 1; 12(5):353-362. [view]
  55. Oldfield BJ, McGinnis KA, Edelman EJ, Williams EC, Gordon AJ, Akgün K, Crystal S, Fiellin LE, Gaither JR, Goulet JL, Korthuis PT, Marshall BDL, Justice AC, Bryant K, Fiellin DA, Kraemer KL. Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV. Journal of substance abuse treatment. 2020 Feb 1; 109:14-22. [view]
  56. Ogbuagu O, Marshall BDL, Tiberio P, Ogunbajo A, Barakat L, Montgomery M, Almonte A, Wray T, Williams EC, Edelman EJ, Chan PA. Prevalence and Correlates of Unhealthy Alcohol and Drug Use Among Men Who Have Sex with Men Prescribed HIV Pre-exposure Prophylaxis in Real-World Clinical Settings. AIDS and behavior. 2019 Jan 1; 23(1):190-200. [view]
  57. Williams EC, Young JP, Achtmeyer CE, Hendershot CS. Primary Care Providers' Interest in Using a Genetic Test to Guide Alcohol Use Disorder Treatment. Journal of substance abuse treatment. 2016 Nov 1; 70:14-20. [view]
  58. Lehavot K, Beckman KL, Chen JA, Simpson TL, Williams EC. Race/Ethnicity and Sexual Orientation Disparities in Mental Health, Sexism, and Social Support among Women Veterans. Psychology of sexual orientation and gender diversity. 2019 Jan 1; 6(3):347-358. [view]
  59. Chen JA, Glass JE, Bensley KMK, Goldberg SB, Lehavot K, Williams EC. Racial/ethnic and gender differences in receipt of brief intervention among patients with unhealthy alcohol use in the U.S. Veterans Health Administration. Journal of substance abuse treatment. 2020 Dec 1; 119:108078. [view]
  60. Bensley KM, Harris AH, Gupta S, Rubinsky AD, Jones-Webb R, Glass JE, Williams EC. Racial/ethnic differences in initiation of and engagement with addictions treatment among patients with alcohol use disorders in the veterans health administration. Journal of substance abuse treatment. 2017 Feb 1; 73:27-34. [view]
  61. Bensley KM, McGinnis KA, Fiellin DA, Gordon AJ, Kraemer KL, Bryant KJ, Edelman EJ, Crystal S, Gaither JR, Korthuis PT, Marshall BDL, Ornelas IJ, Chan KCG, Dombrowski JC, Fortney JC, Justice AC, Williams EC. Racial/ethnic differences in the association between alcohol use and mortality among men living with HIV. Addiction science & clinical practice. 2018 Jan 22; 13(1):2. [view]
  62. Williams EC, Gupta S, Rubinsky AD, Jones-Webb R, Bensley KM, Young JP, Hagedorn H, Gifford E, Harris AH. Racial/Ethnic Differences in the Prevalence of Clinically Recognized Alcohol Use Disorders Among Patients from the U.S. Veterans Health Administration. Alcoholism, clinical and experimental research. 2016 Feb 1; 40(2):359-66. [view]
  63. Chavez LJ, Ornelas IJ, Lyles CR, Williams EC. Racial/ethnic workplace discrimination: association with tobacco and alcohol use. American journal of preventive medicine. 2015 Jan 1; 48(1):42-9. [view]
  64. Shahrir S, Crothers K, McGinnis KA, Chan KCG, Baeten JM, Wilson SM, Butt AA, Pisani MA, Baldassarri SR, Justice A, Williams EC. Receipt and predictors of smoking cessation pharmacotherapy among veterans with and without HIV. Progress in Cardiovascular Diseases. 2020 Mar 1; 63(2):118-124. [view]
  65. Owens MD, Ioannou GN, Tsui JL, Edelman EJ, Greene PA, Williams EC. Receipt of alcohol-related care among patients with HCV and unhealthy alcohol use. Drug and Alcohol Dependence. 2018 Jul 1; 188:79-85. [view]
  66. Lipira L, Williams EC, Nevin PE, Kemp CG, Cohn SE, Turan JM, Simoni JM, Andrasik MP, French AL, Unger JM, Heagerty P, Rao D. Religiosity, Social Support, and Ethnic Identity: Exploring "Resilience Resources" for African-American Women Experiencing HIV-Related Stigma. Journal of acquired immune deficiency syndromes (1999). 2019 Jun 1; 81(2):175-183. [view]
  67. Glass JE, Andréasson S, Bradley KA, Finn SW, Williams EC, Bakshi AS, Gual A, Heather N, Sainz MT, Benegal V, Saitz R. Rethinking alcohol interventions in health care: a thematic meeting of the International Network on Brief Interventions for Alcohol & Other Drugs (INEBRIA). Addiction science & clinical practice. 2017 May 10; 12(1):14. [view]
  68. Williams EC, Frasco MA, Jacobson IG, Maynard C, Littman AJ, Seelig AD, Crum-Cianflone NF, Nagel A, Boyko EJ. Risk factors for relapse to problem drinking among current and former US military personnel: a prospective study of the Millennium Cohort. Drug and Alcohol Dependence. 2015 Mar 1; 148:93-101. [view]
  69. Justice AC, McGinnis KA, Tate JP, Braithwaite RS, Bryant KJ, Cook RL, Edelman EJ, Fiellin LE, Freiberg MS, Gordon AJ, Kraemer KL, Marshall BD, Williams EC, Fiellin DA. Risk of mortality and physiologic injury evident with lower alcohol exposure among HIV infected compared with uninfected men. Drug and Alcohol Dependence. 2016 Apr 1; 161:95-103. [view]
  70. Santos CA, Williams EC, Rodriguez J, Ornelas IJ. Sexual Health in a Social and Cultural Context: a Qualitative Study of Young Latina Lesbian, Bisexual, and Queer Women. Journal of racial and ethnic health disparities. 2017 Dec 1; 4(6):1206-1213. [view]
  71. Richards JE, Shortreed SM, Simon GE, Penfold RB, Glass JE, Ziebell R, Williams EC. Short-term risk of suicide attempt associated with patterns of patient-reported alcohol use determined by routine AUDIT-C among adults receiving mental healthcare. General hospital psychiatry. 2020 Jan 1; 62:79-86. [view]
  72. Trone DW, Powell TM, Bauer LM, Seelig AD, Peterson AV, Littman AJ, Williams EC, Maynard CC, Bricker JB, Boyko EJ. Smoking and drinking behaviors of military spouses: Findings from the Millennium Cohort Family Study. Addictive Behaviors. 2018 Feb 1; 77:121-130. [view]
  73. Oster NV, Williams EC, Unger JM, Newcomb PA, Jacobson EN, deHart MP, Englund JA, Hofstetter AM. Sociodemographic, clinical and birth hospitalization characteristics and infant Hepatitis B vaccination in Washington State. Vaccine. 2019 Sep 10; 37(38):5738-5744. [view]
  74. Williams EC, Matson TE, Harris AHS. Strategies to increase implementation of pharmacotherapy for alcohol use disorders: a structured review of care delivery and implementation interventions. Addiction science & clinical practice. 2019 Feb 12; 14(1):6. [view]
  75. Edelman EJ, Li Y, Barry D, Brennan Braden J, Crystal S, Kerns RD, Gaither JR, Gordon KS, Manhapra A, Merlin JS, Moore BA, Oldfield BJ, Park LS, Rentsch CT, Skanderson M, Williams EC, Justice AC, Tate JP, Becker WC, Marshall BDL. Trajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study. Journal of acquired immune deficiency syndromes (1999). 2020 May 1; 84(1):26-36. [view]
  76. Graf SA, Zeliadt SB, Rise PJ, Backhus LM, Zhou XH, Williams EC. Unhealthy alcohol use is associated with postoperative complications in veterans undergoing lung resection. Journal of thoracic disease. 2018 Mar 1; 10(3):1648-1656. [view]
  77. Rubinsky AD, Chavez LJ, Berger D, Lapham GT, Hawkins EJ, Williams EC, Bradley KA. Utility of routine alcohol screening for monitoring changes in alcohol consumption. Drug and Alcohol Dependence. 2019 Aug 1; 201:155-160. [view]
  78. Williams EC, Gupta S, Rubinsky AD, Glass JE, Jones-Webb R, Bensley KM, Harris AHS. Variation in receipt of pharmacotherapy for alcohol use disorders across racial/ethnic groups: A national study in the U.S. Veterans Health Administration. Drug and Alcohol Dependence. 2017 Sep 1; 178:527-533. [view]
Conference Presentations

  1. Williams EC. Among VA patients with unhealthy alcohol use, those with HIV are less likely than those without to receive brief intervention. Poster session presented at: Research Society on Alcoholism Annual Scientific Meeting; 2016 Jun 26; New Orleans, LA. [view]
  2. Williams EC, Achtmeyer CE, Young JP, Bradley KA, Berger DB, Forehand M, Siegel MB, Curran G, Ludman EJ, Lapham GT, Harris AH. Barriers and facilitators to pharmacotherapy for alcohol use disorders in primary care: results of a qualitative study in 4 VA primary care clinics. Poster session presented at: Research Society on Alcoholism Annual Scientific Meeting; 2015 Jun 22; San Antonio, TX. [view]
  3. Williams EC, Achtmeyer CE, Young JP, Bradley KA, Berger DB, Forehand M, Siegel MB, Curran G, Ludman EJ, Lapham GT, Harris AH. Barriers and facilitators to pharmacotherapy for alcohol use disorders in primary care: results of a qualitative study in 4 VA primary care clinics. Poster session presented at: International Network on Brief Interventions for Alcohol and Other Drugs Conference; 2015 Sep 1; Atlanta, GA. [view]
  4. Williams EC. Documented brief intervention not associated with resolution of unhealthy alcohol use at follow-up screening among VA patients with HIV (Abstract presented). Presented at: International Network on Brief Interventions for Alcohol and Other Drugs Conference; 2016 Sep 12; Lausanne, Switzerland. [view]
  5. Williams EC. Influence of Brief Intervention Implementation on Gender Differences in Receipt of Brief Intervention in the U.S. Veterans Health Administration. Paper presented at: Research Society on Alcoholism Annual Scientific Meeting; 2016 Jun 28; New Orleans, LA. [view]
  6. Williams EC. Primary care providers' interest in using a genetic test to guide alcohol use disorder treatment. Poster session presented at: Research Society on Alcoholism Annual Scientific Meeting; 2016 Jun 28; New Orleans, LA. [view]
  7. Williams EC. Using social marketing theory to segment the market and customize implementation strategies to promote provision of pharmacotherapy for alcohol use disorders in primary care. Poster session presented at: National Institutes of Health / AcademyHealth Conference on the Science of Dissemination and Implementation; 2015 Dec 15; Bethesda, MD. [view]
  8. Williams EC. Variation in receipt of pharmacotherapy for alcohol use disorders across racial/ethnic groups in the U.S. Veterans Health Administration. Presented in the Symposium: 'Racial and ethnic differences in alcohol-related care and outcomes' (Chair: Joseph Glass, PhD). Paper presented at: Addiction Health Services Research Conference; 2015 Oct 15; Marina del Rey, CA. [view]


DRA: Substance Use Disorders, Health Systems
DRE: Technology Development and Assessment, Treatment - Implementation
Keywords: none
MeSH Terms: none

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