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Seattle-Denver Center of Innovation (COIN)

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COIN Investigators & Staff

COIN Investigators


Charles C. Engel, MD, MPH
Title: Core Investigator; Co-Director VA Advanced Fellowship Program in HSR
Professor of Psychiatry and Behavioral Sciences, University of Washington School of Medicine
Location: Seattle
See Dr. Engel's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials


Charles Engel, MD, MPH is Core VA HSR Investigator in the Seattle Center for Innovation, Codirector of the Center's Advanced Research Fellowship on Learning Health Systems, Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, and Adjunct Physician Policy Researcher at the RAND Corporation. A retired Army Colonel and combat veteran, Engel's work has focused on trauma-informed health systems and strategies for improving the quality of primary care for chronic mental and physical health conditions following war and other occupationally related exposures. Health conditions of research interest have included polytraumatic injuries and occupational trauma syndromes ranging from blast injury, mild traumatic brain injury, chronic pain and fatigue, Gulf War syndrome, military sexual trauma, PTSD and depression.

Engel is an experienced, mixed qualitative and quantitative research methodologist, having led a number of large pragmatic randomized trials, program evaluations, and implementation science studies. He has authored or coauthored nearly 200 scholarly papers, including in the New England Journal of Medicine, JAMA, and the American Journal of Psychiatry. Funding for his work has come from the National Institutes of Health, Centers for Disease Control, Department of Veterans Affairs, Department of Defense and other organizations. Before joining UW Psychiatry and the AIMS Center in 2021, Dr. Engel was Senior Physician Policy Researcher at the RAND Corporation from 2013 to 2020 and Associate Chair (Research) at Uniformed Services University's Department of Psychiatry from 2001-2013. Engel has served on the board of directors of the International Society for Traumatic Stress Studies, has testified twice before Congress, received a number of awards, and delivered invited lectures in over 10 countries. He received both his MD and MPH from the University of Washington School of Medicine.

The following images visualize Dr. Engel's work. The word cloud is drawn from publication titles. The research collaboration map shows research relationships (click the image to enlarge):

Dr. Engel's publication titles indicate their primary work is care of Veterans
Word cloud from pub titles
Dr. Engel's collaborations are primarily from the RAND Corporation
Research collaboration map
The following research fields have been used to summarize Dr. Engel's publications and grants.
Publications Grants
Clinical Research Mental Health
Mental Health Health Services
Behavioral and Social Science Anxiety Disorders
Brain Disorders Behavioral and Social Science
Post-Traumatic Stress Disorder (PTSD) Brain Disorders
Health Services Clinical Research
Anxiety Disorders Clinical Trials and Supportive Activities
Depression Post-Traumatic Stress Disorder (PTSD)
Clinical Trials and Supportive Activities Depression
Prevention Mind and Body

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California Statewide ACEs Learning Collaborative: A Data Hub Supporting the Implementation of Screening for Childhood Trauma

Role: Co-PI
This project evaluates the implementation of a State Surgeon General mandated screening for childhood trauma (ACEs) in children and adults receiving Medi-Cal system primary care. Qualitative research assesses potential adverse effects of screening from the perspective of patients/parents and the intended and unintended effects of program implementation from the perspective of participating practices. A quantitative data hub for ongoing implementation evaluation will be assessed for feasibility and potential development.
Funder: State of California Department of Health Care Services and University of California, San Francisco

Tenth Department of Defense Blast Injury Research State-of-the-Science Meeting: Developing DoD Research Priorities and Strategies

Role: Co-PI
This project is a mixed method (literature review, scientific meeting, consensus committee) evaluation of the DoD research portfolio pertaining to a topic in blast-related injury. The primary goal is to develop objective, independent recommendations for DoD research and research policy priorities relating to an important topic in Blast Injury Research. The central topic is currently under consideration.
Funder: Office of the Secretary of Defense, Defense Health Agency

Comparative Effectiveness PTSD Trial of Sequenced Pharmacotherapy and Psychotherapy in Primary Care

Role: Co-PI
This is a large, multisite randomized pragmatic clinical trial, to be completed in two large US comparing the effectiveness of primary care PTSD treatment sequencing strategies involving Written Exposure Therapy and commonly used selective serotonin reuptake inhibitors (SSRIs) and a serotonin-norepinephrine reuptake inhibitor (SNRI).
Funder: Patient Centered Outcomes Research Institute (PCORI)

Ninth Blast Related Injury State-of-the-Science Research Portfolio Evaluation

Role: PI
This project was a mixed method (literature review, scientific meeting, consensus committee) evaluation of the DoD research portfolio pertaining to a topic in blast-related injury. The stakeholder selected topic was "Mitigating the Impact of Blast-related Burn Injuries: From Prolonged Field Care to Rehabilitation and Resilience".
Funder: Office of the Secretary of Defense

Evaluating the Quality and Safety of Pain Care and Opioid Prescribing in the Military Health System

Role: Co-I
This project is an evaluation of the US Military Health System’s pain care and opioid prescribing using automated health system data sources.
Funder: Office of the Assistant Secretary of Defense for Health Affairs

DoD-Wide Assessment of Blast Related Brain Health Research Portfolio Evaluation

Role: PI
This project is a mixed methods evaluation of the DoD blast-related research portfolio pertaining to traumatic brain injury and psychological health from 2007-2018.
Funder: Office of the Secretary of Defense

Confidentiality of Military Mental Health Services: Comparison of Military and Civilian Standards and Perceptions of Military Stakeholders

Role: Co-PI
This project is a mixed methods evaluation of DoD mental health care confidentiality standards.
Funder: Office of the Secretary of Defense

2018 Department of Defense Health-Related Behaviors Survey of Active and Reserve Component Personnel

Role: Co-PI
This project is a large population-based survey of behavioral health and health-related behaviors among a representative sample of active and reserve component U.S. military personnel from all branches of service, the Marine Corps, and Coast Guard.
Funder: Office of the Secretary of Defense

Development of a Knowledge Readiness Level Framework for Medical Research

Role: Co-PI
This project involved the development and early testing of a translational research framework for quantitative prediction of future population impact of health research.
Funder: Office of the Secretary of Defense

Post Admission Cognitive Therapy (PACT) for the Inpatient Treatment of Military Personnel with Suicidal Behaviors

Role: Co-PI
This project is a multisite randomized trial of a cognitive therapy (versus usual care) intervention for suicidal military health system beneficiaries (including active duty military) hospitalized at two large military medical center inpatient psychiatric facilities. Follow-up is for 12 months with primary outcomes being time to recurrent suicide attempt and number of future suicide attempts.
Funder: Military Occupational Medicine Research Program Award

Randomized Effectiveness Trial of a Systems-Level Approach to Stepped Care for War-Related PTSD

Role: PI
This project was a 6-site randomized controlled trial of a collaborative care intervention for service members with PTSD and depression seeking primary care in the military health system. The study compared the model to usual care over one year with research assessments at baseline and 3-, 6-, and 12-month follow-up. Other studies that were part of the project involved (1) qualitative research to assess the acceptability of the care delivery model for primary care providers and patients and (2) cost-effectiveness analysis.
Funder: Clinical Trial Award Department of Defense Deployment-Related Medical Research Program

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Recent Publications


Fortney JC, Kaysen DL, Engel CC, Cerimele JM, Nolan JP Jr, Chase E, Blanchard BE, Hauge S, Bechtel J, Moore DL, Taylor A, Acierno R, Nagel N, Sripada RK, Painter JT, DeBeer BB, Bluett E, Teo AR, Morland LA, Heagerty PJ. Sequenced treatment effectiveness for posttraumatic stress (STEPS) trial: A protocol for a pragmatic comparative effectiveness trial with baseline results. Contemp Clin Trials. 2024 Jun 10:107606. doi: 10.1016/j.cct.2024.107606. Epub ahead of print.
PMID: 38866094
Learn more about this publication on Dimensions


Hepner KA, Sousa JL, Roth CP, Huilgol SS, Jean C, Schulson LB, Gandhi P, Malika N, Engel CC. Improving Pain Care for Service Members: Administrator, Provider, and Patient Perspectives on Treatment, Policies, and Opportunities for Change. Rand Health Q. 2023 Dec 20;11(1):3. PMCID: PMC10732241.
PMID: 38264313

Reed DE, Engel CC, DeFaccio R, Gaj L, Douglas JH, Williams RM, Etingen B, Kroenke K, Bokhour BG, Zeliadt SB. Examining the Veterans Health Administration whole health model of care within the context of posttraumatic stress disorder. Psychol Serv. 2023 Dec 11. doi: 10.1037/ser0000822. Epub ahead of print.
PMID: 38079475
Learn more about this publication on Dimensions

Reed DE, Williams RM, Engel CC, Zeliadt SB. Introducing the integrated model of co-occurring chronic pain and posttraumatic stress disorder: Adding meaning-making and existential concepts to current theory. Psychol Trauma. 2023 Oct 19. doi: 10.1037/tra0001591. Epub ahead of print.
PMID: 37856393
Learn more about this publication on Dimensions

Dunbar MS, Breslau J, Collins R, Beckman R, Engel CC. Heterogeneity in Unmet Treatment Need and Barriers to Accessing Mental Health Services Among U.S. Military Service Members with Serious Psychological Distress. Adm Policy Ment Health. 2023 Aug 18. doi: 10.1007/s10488-023-01289-4. Epub ahead of print.
PMID: 37596460
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Reed DE, Chen C, Harvey K, Engel CC, Kroenke K, Defaccio R, Coggeshall S, Taylor SL, Bokhour BG, Zeliadt SB. Utilization of Whole Health and Longitudinal Outcomes After Screening Positive for Possible Depression Documented in Veterans Health Administration's Electronic Health Record. J Integr Complement Med. 2023 Apr 11. doi: 10.1089/jicm.2022.0772. Epub ahead of print.
PMID: 37040272
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Hepner KA, Roth CP, Sherry TB, McBain RK, Ruder T, Engel CC. Assessing the Quality of Outpatient Pain Care and Opioid Prescribing in the Military Health System. Rand Health Q. 2022 Aug 31;9(4):19. PMCID: PMC9519116. PMID: 36238003.

Tomoaia-Cotisel A, Eberhart NK, Engel CC, Mendel P, Alvarado G, Qureshi N, Allen SD. A Process Evaluation of Primary Care Behavioral Health Integration in the Military Health System. Rand Health Q. 2022 Jun 30;9(3):15. PMCID: PMC9242578. PMID: 35837508.

Meyer EG, DeSilva RB, Hann MC, Aggarwal NK, Brim WL, Engel CC, Lu FG, Lewis-Fernández R. Adapting the Cultural Formulation Interview for the Military. Psychiatr Serv. 2022 Feb 23:appips202100523. doi: 10.1176/ Epub ahead of print. PMID: 35193377.
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Reed DE 2nd, Bokhour BG, Gaj L, Barker AM, Douglas JH, DeFaccio R, Williams RM, Engel CC, Zeliadt SB. Whole Health Use and Interest Across Veterans With Co-Occurring Chronic Pain and PTSD: An Examination of the 18 VA Medical Center Flagship Sites. Glob Adv Health Med. 2022 Feb 11;11:21649561211065374. doi: 10.1177/21649561211065374. PMCID: PMC8841911. PMID: 35174004. Learn more about this publication on Dimensions



Littman AJ, Bratman GN, Lehavot K, Engel CC, Fortney JC, Peterson A, Jones A, Klassen C, Brandon J, Frumkin H. Nature versus urban hiking for Veterans with post-traumatic stress disorder: a pilot randomised trial conducted in the Pacific Northwest USA. BMJ Open. 2021 Sep 23;11(9):e051885. doi: 10.1136/bmjopen-2021-051885. PMID: 34556516

Dunbar MS, Schuler MS, Meadows SO, Engel CC. Associations Between Mental and Physical Health Conditions and Occupational Impairments in the U.S. Military. Mil Med. 2021 Feb 3:usab021. doi: 10.1093/milmed/usab021. Epub ahead of print. PMID: 33533897



Malâtre-Lansac A, Engel CC, Xenakis L, Carlasare L, Blake K, Vargo C, Botts C, Chen PG, Friedberg MW. Factors Influencing Physician Practices' Adoption of Behavioral Health Integration in the United States: A Qualitative Study. Ann Intern Med. 2020 Jul 21;173(2):92-99. doi: 10.7326/M20-0132. Epub 2020 Jun 2. PMID: 32479169



Novak LA, Belsher BE, Freed MC, McCutchan PK, Liu X, Evatt DP, Tanielian T, Bray RM, Engel CC. Impact of financial reimbursement on retention rates in military clinical trial research: A natural experiment within a multi-site randomized effectiveness trial with active duty service members. Contemp Clin Trials Commun. 2019 Apr 13;15:100353. doi: 10.1016/j.conctc.2019.100353. PMCID: PMC6477623. PMID: 31032460