# Validation of a Pragmatic Implementation Measure for Task Sharing in Mental Health Services

> **NIH NIH R01** · NEW YORK UNIVERSITY · 2021 · $460,540

## Abstract

ABSTRACT
To address the shortage of mental health specialists worldwide, with as few as 2 per 100,000 population in
many low- and middle-income countries (LMICs), researchers and program implementers are using task
sharing strategies, which involve delegating the provision of mental health care to a broader cadre of
nonspecialists such as primary care physicians, community health workers, lay volunteers, and the service
users themselves (i.e., peers). While evidence demonstrates that task sharing for mental health strategies is
effective in improving detection and treatment for a range of mental disorders, there remains a lack of critical
knowledge on how to successfully implement and scale up task-sharing strategies in real-world settings. To
address this gap, the proposed study seeks to validate the Barriers and Facilitators in Implementation of
Task Sharing in Mental Health (BeFITS-MH) measure, a multi-dimensional, multi-stakeholder tool we
developed to enable the systematic and rapid assessment of core, modifiable barriers and facilitators factors.
We developed BeFITS-MH using a multi-level conceptual model that we derived from influential
implementation science frameworks, and analyzed qualitative data from three NIMH-funded global “hubs” and
a systematic review of barriers and facilitators identified in the literature. BeFITS-MH assesses perspectives
from clients and providers, on 6 domains: 1) role fit; 2) satisfaction and motivation; 3) provider competence;
4) contextual congruence; 5) service accessibility; and 6) support systems. This study seeks to evaluate the
psychometric and pragmatic properties of BeFITS-MH in 3 ongoing NIMH studies across 3 countries. Our
Specific Aims are: Aim 1: Finalize the BeFITS-MH tool by finalizing the tool via a modified Delphi process
and piloting the tool to evaluate the initial content validity and pragmatic qualities (i.e., time to complete). Aim
2: Evaluate the psychometric properties of BeFITS-MH tool. Following current Psychometric Evidence
Scale criteria, we will evaluate internal consistency, norms, responsiveness, structural validity, convergent
validity, discriminant validity, known-groups validity, and predictive validity. The tool will be validated against
three implementation outcomes: acceptability, appropriateness, and feasibility, and process indicators at each
site across two timepoints of data collection. Aim 3: Assess the pragmatic qualities and cross-national
utility of BeFITS-MH. We will further understanding of implementation science and conceptual frameworks for
TSMH strategies by exploring structural validity of the BeFITS-MH scales across sites. This research will
contribute to NIMH Strategic Plan Objective 4: “Strengthen the Public Health Impact of NIMH-Supported
Research.” This study will also enable identification of core latent variables underlying modifiable barriers and
facilitators across diverse contexts, thus advancing conceptualization of causal relationships among
imple...

## Key facts

- **NIH application ID:** 10149413
- **Project number:** 5R01MH122851-02
- **Recipient organization:** NEW YORK UNIVERSITY
- **Principal Investigator:** Judith Karen Bass
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $460,540
- **Award type:** 5
- **Project period:** 2020-05-01 → 2024-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10149413

## Citation

> US National Institutes of Health, RePORTER application 10149413, Validation of a Pragmatic Implementation Measure for Task Sharing in Mental Health Services (5R01MH122851-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10149413. Licensed CC0.

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