Seattle-Denver Center of Innovation (COIN)

COIN Investigators & Staff

COIN Investigators

Jessica A Chen, PhD

Title: Core Investigator; Career Development Awardee
Assistant Professor, University of Washington School Medicine

Contact: Jessica.Chen663@va.gov

Location: Seattle

University of Washington webpage

See Dr. Chen's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials

I am a clinical psychologist. I study care for chronic pain, trauma, and related mental health and substance use disorders. I focus on whether the care received for these conditions is equitable – does everyone who needs treatment get it, and what is the quality of that care? I also study how social policies interact with health care to create different resources and circumstances for different groups of people.

One of my favorite parts of this work is working alongside Veterans as partners in research. As a clinician and therapist, I have enjoyed working directly with Veterans and seeing their lives improve. With research, I get to collaborate with Veterans to generate knowledge and solutions that can impact an entire healthcare system and improve the lives of many people at once.

I hope that the work we do changes how patients and providers think about chronic pain care by expanding people’s ideas of what is possible when it comes to improving quality of life while living with chronic pain. I hope that our work changes systems so that they are more just and healing.

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Grants

Cooperative Pain Education and Self-management: Expanding Treatment for Real-World (COPES EXTRA)

Role: Site Lead
Cognitive behavioral therapy for chronic pain (CBT-CP) is an evidence-based intervention that effectively reduces pain and improves function for Veterans with chronic pain. Yet, numerous barriers exist to the widespread implementation of traditional CBT-CP, including patient travel limitations, frequent in-person sessions, and more trained therapists.
Because technology-based interventions, like interactive voice response (IVR), allow patients to engage in treatment from their homes, they may improve access to CBT-CP.
The current project aims to compare the real-world effectiveness of IVR-delivered CBT-CP compared to in-person CBT-CP in VHA settings.
Funder: National Center for Complementary & Integrative Health
NIH website

Patient Readiness for Improvement through Motivation, Engagement, and Decision-making for PTSD (PRIMED-PTSD)

Role: PI
PTSD is one of the most common mental health conditions affecting Veterans and is associated with significant burden. Highly effective treatments exist for PTSD, such as evidence-based psychotherapies, but very few Veterans receive them. Although VA has trained over 8,500 providers in evidence-based psychotherapies for PTSD over the past ten years, only 6% of the 650,000 VHA patients with PTSD receive evidence-based psychotherapy.
It is critical that we connect Veterans with our most effective PTSD treatments and that we do so in a way that is Veteran-centered. Shared decision-making is a patient-centered approach to choosing healthcare treatment options. Evidence shows it increases patients’ motivation for treatment and ability to stay in treatment long enough to benefit. It also helps providers align their practice with evidence-based guidelines.
This proposal will refine and pilot test a shared decision-making intervention for PTSD in VA primary care clinics, where most Veterans with PTSD receive treatment.
Funder: Veterans Affairs
NIH website
Publications of Note: — Provider Perspectives on Implementing Shared Decision Making for PTSD Treatment in VA Primary Care
— Receipt of evidence-based alcohol-related care in a national sample of transgender patients with unhealthy alcohol use: Overall and relative to non-transgender patients

Evaluating the National Implementation of Virtual Interdisciplinary Pain Care Teams - TelePain

Role: PI

Chronic pain is one of the most prevalent and disabling conditions affecting Veterans. One of the Veterans Health Administration’s (VHA’s) most pressing national clinical priorities is to increase access to non-pharmacological pain management and improve the safety of opioid prescribing.
The National Pain Management and Opioid Safety Program (PMOP) implements virtual interdisciplinary pain management teams, TelePain, to improve access to evidence-based pain care among rural Veterans and those served by smaller VA facilities.
The proposed evaluation, developed closely with PMOP, uses a rigorous prospective design to evaluate TelePain’s impact on clinical outcomes for Veterans and costs to VHA while also evaluating TelePain’s impact on access to care and other implementation outcomes. These findings will provide actionable information to improve ongoing TelePain implementation efforts and inform VHA of the potential sustainability of TelePain as a model of care.
Funder: Veterans Affairs
NIH website
Publications of Note:
— "There’s a huge benefit just to know that someone cares:" a qualitative examination of rural veterans’ experiences with TelePain
— Telehealth and Rural-Urban Differences in Receipt of Pain Care in the Veterans Health Administration
— For more information and a well done infographic

Applying Critical Race Theory to investigate the impact of COVID-19-related policy changes on racial/ethnic disparities in medication treatment for opioid use disorder

Role: Co-PI with Emily Williams
With the rise in opioid use disorder (OUD) and overdose, racialized disparities in buprenorphine access and use are a significant concern nationally. Studies estimate that Black patients with OUD are 50-60% less likely to access buprenorphine than White patients, and similar disparities exist for Hispanic/Latinx patients.
COVID-19-related policy changes increased flexibility in providing buprenorphine and other effective medications for OUD over telehealth. They presented an unprecedented opportunity to examine the impacts of a structural intervention—relaxed MOUD restrictions—on disparities that result from structural racism and discrimination (SRD).
The proposed study, guided by Public Health Critical Race Praxis, will use data from the nation's largest provider of substance use care and quantitative and qualitative methods to examine the impact of these policy changes on racialized disparities for Black and Hispanic/Latinx patients to inform future policy and interventions to improve equitable care for OUD.
Funder: National Institute on Drug Abuse
NIH website

Examination of Medication for Opioid Use Disorder Outcomes at High- and Low-Disparity Sites in VA

Role: Co-PI
Funder: Veterans Affairs, Office of Mental Health and Suicide Prevention

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Recent Publications

2024

Bachrach RL, Frost MC, Fletcher OV, Chen JA, Chinman M, Ellis R, Williams EC. Receipt of Medications for Alcohol Use Disorder in the Veterans Health Administration: Comparison of Rates at the Intersections of Racialized and Ethnic Identity With Both Sex and Transgender Status. J Addict Med. 2024 Jun 6. doi: 10.1097/ADM.0000000000001323. Epub ahead of print.
PMID: 38842176

Javier SJ, Carey EP, Gunzburger E, Chen HP, Zeliadt SB, Williams EC, Chen JA. Pain Care Disparities and the Use of Virtual Care Among Racial-Ethnic Minority Groups During COVID-19. J Gen Intern Med. 2024 Jan 22. doi: 10.1007/s11606-023-08473-0. Epub ahead of print.
PMID: 38252245.

Soyer EM, Frost MC, Fletcher OV, Ioannou GN, Tsui JI, Edelman EJ, Weiner BJ, Bachrach RL, Chen JA, Williams EC. Perspectives of clinical stakeholders and patients from four VA liver clinics to tailor practice facilitation for implementing evidence-based alcohol-related care. Addict Sci Clin Pract. 2024 Jan 10;19(1):3. doi: 10.1186/s13722-023-00429-3. PMCID: PMC10782537.
PMID: 38200496

2023

Lundberg DJ, Chen JA. Structural ableism in public health and healthcare: a definition and conceptual framework. Lancet Reg Health Am. 2023 Dec 18;30:100650. doi: 10.1016/j.lana.2023.100650. PMCID: PMC10770745.
PMID: 38188095.
Learn more about this publication on Dimensions

Chen JA, Shofer J, Barnes ML, Livingston WS, Upham M, Simpson TL. Military Sexual Trauma As a Risk Factor for Treatment Non-Response from an Online, Self-Management Posttraumatic Stress Disorder Treatment for Women Veterans. J Interpers Violence. 2023 Dec 11:8862605231216722. doi: 10.1177/08862605231216722. Epub ahead of print.
PMID: 38073465
Learn more about this publication at Dimensions

Austin EJ, Chen J, Briggs ES, Ferro L, Barry P, Heald A, Merrill JO, Curran GM, Saxon AJ, Fortney JC, Ratzliff AD, Williams EC. Integrating Opioid Use Disorder Treatment Into Primary Care Settings. JAMA Netw Open. 2023 Aug 1;6(8):e2328627. doi: 10.1001/jamanetworkopen.2023.28627. PMCID: PMC10422185.
PMID: 37566414
Learn more about this publication at Dimensions

Yang JP, Do QA, Nhan ER, Chen JA. A mixed-methods study of race-based stress and trauma affecting Asian Americans during COVID. Clin Psychol Sci. 2023 Jul 11;2023:21677026231180810. doi: 10.1177/21677026231180810. PMCID: PMC10345399.
PMID: 37578208
Learn more about this publication at Dimensions

Fortney JC, Rajan S, Chen JA, Campbell SB, Nolan JP, Wong E, Sayre G, Petrova V, Simons CE, Reisinger HS, Schnurr PP. A mixed-methods evaluation of why an implementation trial failed to engage veterans with posttraumatic stress disorder in trauma-focused psychotherapy. J Trauma Stress. 2023 Jun 27. doi: 10.1002/jts.22946. Epub ahead of print.
PMID: 37370238
Learn more about this publication at Dimensions

2022

Subramaniam S, Chen J, Wilkerson TL, Stevenson L, Kincaid C, Firestone C, Ball SL. Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry. J Technol Behav Sci. 2022 Dec 6:1-11. doi: 10.1007/s41347-022-00288-w. Epub ahead of print. PMCID: PMC9734451. PMID: 36530381
Learn more about this publication at Dimensions

Silvestrini M, Chen JA. "It's a sign of weakness": Masculinity and help-seeking behaviors among male veterans accessing posttraumatic stress disorder care. Psychol Trauma. 2022 Oct 6. doi: 10.1037/tra0001382. Epub ahead of print. PMID: 36201833
Learn more about this publication at Dimensions

Chen JA, Anderson ML, Cherkin DC, Balderson BH, Cook AJ, Sherman KJ, Turner JA. Moderators and Nonspecific Predictors of Treatment Benefits in a Randomized Trial of Mindfulness-Based Stress Reduction vs. Cognitive-Behavioral Therapy vs. Usual Care for Chronic Low Back Pain. J Pain. 2022 Sep 27:S1526-5900(22)00413-8. doi: 10.1016/j.jpain.2022.09.014. Epub ahead of print. PMID: 36180008
Learn more about this publication at Dimensions

Fletcher OV, Chen JA, van Draanen J, Frost MC, Rubinsky AD, Blosnich JR, Williams EC. Prevalence of social and economic stressors among transgender veterans with alcohol and other drug use disorders. SSM Popul Health. 2022 Jun 28;19:101153. doi: 10.1016/j.ssmph.2022.101153. PMCID: PMC9260617. PMID: 35813187
Learn more about this publication at Dimensions

Munson SA, Friedman EC, Osterhage K, Allred R, Pullmann MD, Areán PA, Lyon AR; UW ALACRITY Center Researchers. Usability Issues in Evidence-Based Psychosocial Interventions and Implementation Strategies: Cross-project Analysis. J Med Internet Res. 2022 Jun 14;24(6):e37585. doi: 10.2196/37585. PMID: 35700016
Learn more about this publication at Dimensions

Matson TE, Harris AHS, Chen JA, Edmonds AT, Frost MC, Rubinsky AD, Blosnich JR, Williams EC. Influence of a national transgender health care directive on receipt of alcohol-related care among transgender Veteran Health Administration patients with unhealthy alcohol use. J Subst Abuse Treat. 2022 May 24:108808. doi: 10.1016/j.jsat.2022.108808. Epub ahead of print. PMID: 35715286
Learn more about this publication at Dimensions

2021

Cheng ZH, Fujii D, Wong SN, Davis DM, Rosner CM, Chen JA, Bates J, Jackson J. What matters to psychology trainees when making decisions about internship and postdoctoral training sites: Differences between racial/ethnic minority and White VA trainees. Psychol Serv. 2021 Nov 18. doi: 10.1037/ser0000587. Epub ahead of print.
PMID: 34793188.

Silvestrini M, Indresano J, Zeliadt SB, Chen JA. "There's a huge benefit just to know that someone cares:" a qualitative examination of rural veterans' experiences with TelePain. BMC Health Serv Res. 2021 Oct 16;21(1):1111. doi: 10.1186/s12913-021-07133-5.
PMID: 34656133.

Chen JA, Jakupcak M, McCann R, Fickel JJ, Simons CE, Campbell DG, Stryczek KC, Hoerster KD, Chaney EF, Oishi SM, Miner MN, Bonner LM, Fortney JC, Felker BL. Posttraumatic stress disorder collaborative care: A quality improvement study in veterans affairs primary care. Fam Syst Health. 2021 Jun;39(2):198-211. doi: 10.1037/fsh0000623.
PMID: 34410768.

Williams EC, Chen JA, Frost MC, Rubinsky AD, Edmonds AT, Glass JE, Lehavot K, Matson TE, Wheat CL, Coggeshall S, Blosnich JR. Receipt of evidence-based alcohol-related care in a national sample of transgender patients with unhealthy alcohol use: Overall and relative to non-transgender patients. J Subst Abuse Treat. 2021 Jul 8:108565. doi: 10.1016/j.jsat.2021.108565. Epub ahead of print.
PMID: 34274175.

Chen JA, DeFaccio RJ, Gelman H, Thomas ER, Indresano JA, Dawson TC, Glynn LH, Sandbrink F, Zeliadt SB. Telehealth and rural-urban differences in receipt of pain care in the Veterans Health Administration. Pain Med. 2021 Jun 18:pnab194. doi: 10.1093/pm/pnab194. Epub ahead of print.
PMID: 34145892.

Chen JA, Matson TE, Lehavot K, Raue PJ, Young JP, Silvestrini MC, Fortney JC, Williams EC. Provider Perspectives on Implementing Shared Decision Making for PTSD Treatment in VA Primary Care. Adm Policy Ment Health. 2021 Feb 24. doi: 10.1007/s10488-021-01119-5. Epub ahead of print.
PMID: 33625623

Williams EC, Frost MC, Rubinsky AD, Glass JE, Wheat CL, Edmonds AT, Chen JA, Matson TE, Fletcher OV, Lehavot K, Blosnich JR. Patterns of Alcohol Use Among Transgender Patients Receiving Care at the Veterans Health Administration: Overall and Relative to Nontransgender Patients. J Stud Alcohol Drugs. 2021 Jan;82(1):132-141.
PMID: 33573731

Frost MC, Blosnich JR, Lehavot K, Chen JA, Rubinsky AD, Glass JE, Williams EC. Disparities in Documented Drug Use Disorders Between Transgender and Cisgender U.S. Veterans Health Administration Patients. J Addict Med. 2020 Nov 25. doi: 10.1097/ADM.0000000000000769. Epub ahead of print.
PMID: 33252409

2020

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. J Subst Abuse Treat. 2020 Dec;119:108078. doi: 10.1016/j.jsat.2020.108078. Epub 2020 Jul 15. PMCID: PMC7641963.
PMID: 32736926

Goldberg SB, Fortney JC, Chen JA, Young BA, Lehavot K, Simpson TL. Military Service and Military Health Care Coverage are Associated with Reduced Racial Disparities in Time to Mental Health Treatment Initiation. Adm Policy Ment Health. 2020 Jul;47(4):555-568. doi: 10.1007/s10488-020-01017-2. PMCID: PMC7357226.
PMID: 31989399

Glynn LH, Chen JA, Dawson TC, Gelman H, Zeliadt SB. Bringing chronic-pain care to rural veterans: A telehealth pilot program description. Psychol Serv. 2020 Jan 16. doi: 10.1037/ser0000408. Epub ahead of print.
PMID: 31944817

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. Psychol Sex Orientat Gend Divers. 2019;6(3):347-358. doi: 10.1037/sgd0000333. PMC6703561
PMID: 31435497

2019

Chen JA. Capsule Commentary on Sullivan et al., Primary Care Opioid Taper Plans Are Associated with Sustained Opioid Dose Reduction. J Gen Intern Med. 2020 Mar;35(3):980. doi: 10.1007/s11606-019-05520-7. Epub 2019 Nov 11. PMCID: PMC7080926.
PMID: 31713038

Browne KC, Chen JA, Hundt NE, Hudson TJ, Grubbs KM, Fortney JC. Veterans self-reported reasons for non-attendance in psychotherapy for posttraumatic stress disorder. Psychol Serv. 2019 Jul 22:10.1037/ser0000375. doi: 10.1037/ser0000375. Online ahead of print. PMC7147996
PMID: 31328929

Goldberg SB, Simpson TL, Lehavot K, Katon JG, Chen JA, Glass JE, Schnurr PP, Sayer NA, Fortney JC. Mental Health Treatment Delay: A Comparison Among Civilians and Veterans of Different Service Eras. Psychiatr Serv. 2019 May 1;70(5):358-366. doi: 10.1176/appi.ps.201800444. Epub 2019 Mar 7. PMC6510540
PMID: 30841842

Spottswood M, Fortney J, Chen JA, Davydow D, Huang H. Posttraumatic Stress Disorder in the Primary Care Setting: Summary of Recommended Care. Harv Rev Psychiatry. 2019 Mar/Apr;27(2):87-93. doi: 10.1097/HRP.0000000000000201.
PMID: 30614927

Chen JA, Fortney JC, Bergman HE, Browne KC, Grubbs KM, Hudson TJ, Raue PJ. Therapeutic alliance across trauma-focused and non-trauma-focused psychotherapies among veterans with PTSD. Psychol Serv. 2020 Nov;17(4):452-460. doi: 10.1037/ser0000329. Epub 2019 Feb 11. PMCID: PMC6689461.
PMID: 30742471

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Media (Video, Podcast, Other)

Podcast: Menders: Love & Leadership in Health Systems - Space to thrive for women of color with Dr. Jessica Chen

JUNE 27, 2022
DR. NICOLA DE PAUL, SEASON 1, EPISODE 12

Listen at: https://mendersloveleadershipinhealthsystems.buzzsprout.com/1971466/10823461

Dr. Jessica Chen is a clinical psychologist and Assistant Professor at the University of Washington.

She has focused her career on trauma-focused psychotherapy and research designed to promote health equity for underserved population.

In this episode, she shares some of her experiences as a woman of color navigating the challenges of academic medicine and other healthcare spaces not designed to empower women of color.

Listen to find out why she believes that women of color make the best bosses!

And, then consider what you can do as a healthcare leader to share your power and create resilient and supportive spaces for people of color. Hint, it starts with recruiting people of color or other marginalized identities who specialize in creating safe and supportive spaces to join your organization!

Enjoy!

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