HSR&D Research Career Scientist Award Application

Veterans Admin Palo Alto Health Care Sys, Palo Alto CA

Investigators

Abstract

Dr. Humphreys is a Senior Research Career Scientist who conducts health services research in the area of substance use disorder and its related comorbidities (e.g., depression, PTSD). These prevalent disorders contribute to substantial morbidity and mortality in the Veteran population. The substance use disorder interventions Dr. Humphreys studies are broad, ranging from professionally-operated and delivered treatment programs, mutual help groups operated by peers, and Internet-delivered treatments that are largely self-administered. His work has addressed all aspects of these different types of intervention, including their accessibility, outcomes, costs and mechanisms of action. Dr. Humphreys has also pursued a line of research focused on the system and policy environment of mental health services. This work has comprised studies of how VA care managers make policy decisions, how funding and legislation shapes services in the VA and outside of it, and how staffing patterns and practices influence the nature of mental health care. In addition to these substantive foci, Dr. Humphreys has contributed to improving health services research methods. This includes developing and validating measures of phenomenon in the field (e.g., health care staff beliefs about addiction, mutual help group involvement) that have since become widely- used. It also comprises adapting well-established statistical methods from other fields (e.g., cluster analysis, instrumental variables modelling) to the central questions of mental health services research. A particularly influential aspect of Dr. Humphreys' methodological work focuses on the demographic and clinical representativeness of clinical trial samples and how such samples differ from patients seen in everyday practice. This work comprises original empirical studies as well as integrative literature reviews. This scientific program addresses clinical translation questions (e.g., is it safe to generalize from an unrepresentative sample?) as well as ethical issues (e.g., Does trial sample unrepresentativeness have a disparate impact on women and people of color?). This research program has generated significant international interest, inspiring replications in other countries in addition to sparking interest within VA nationally. Dr. Humphreys has also put extensive effort into translating all of the above research findings into policies that improve health care for Veterans and for the nation as a whole. This has included serving on Secretarial and Under Secretarial VA initiatives focused on care improvement, helping craft the U.S. Surgeon General's first report on addiction, and advising state and local officials on how to better tackle addiction. Dr. Humphreys' research has been presented to Congressional Committees by national VA leadership on many occasions, and has also been employed extensively within VA Central Office to make consequential decisions about the shape of VA mental health services nationally.