# A type II hybrid implementation-effectiveness study of BECOME (BEhavioral Community-based COmbined Intervention for MEntal Health and Noncommunicable Diseases) delivered by community health workers

> **NIH MH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2026 · $631,957

## Abstract

Project Abstract
 Common mental health disorders (CMDs), like depression and anxiety, and non-communicable
diseases (NCDs), like diabetes and hypertension, are highly prevalent and are the leading causes of death and
disability worldwide, especially in low-resource settings like our research site in Nepal. Comorbidity among
CMDs and NCDs is high and the relationship between these conditions is complex and multidirectional.
Several common behavioral risk factors worsen both conditions: stress, isolation, tobacco use, low physical
activity, low quality diet, and poor treatment adherence. Behavioral interventions can address these common
risk factors, and improve CMDs and NCDs. The World Health Organization's (WHO) two clinical protocols for
CMDs and NCDs recommend three behavioral interventions: a) evidence-based stress reduction (EBSR) for
stress/anxiety; b) behavioral activation (BA) for depression; and c) motivational interviewing (MI) for healthy
behaviors. Despite this potential, these interventions are rarely available in low-resource settings because of
two important gaps: 1) behavioral interventions have often been studied for one or two CMDs and NCDs,
rather than for the real-world need of an integrated intervention to simultaneously address multiple CMDs and
NCDs; and 2) these interventions have not been studied using implementation strategies that can support easy
access (i.e., making care available at or near the patient's home) and sustained implementation in real-world
settings. Based on our extensive history and long-term commitment to working in Nepal, we now propose a
hybrid implementation-effectiveness study of BECOME (BEhavioral Community-based COmbined Intervention
for MEntal Health and Noncommunicable Diseases) delivered by community health workers (CHWs) in Nepal.
 Our team has a long-standing history of conducting implementation research, integrating evidence-
based care for CMDs and NCDs into existing health-care systems in Nepal, training CHWs

## Key facts

- **NIH application ID:** 11396315
- **Project number:** 5R01MH133231-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Bibhav  Acharya; Sabitri  Sapkota
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** MH
- **Fiscal year:** 2026
- **Award amount:** $631,957
- **Award type:** 5
- **Project period:** 2023-07-01T00:00:00 → 2028-04-30T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11396315

## Citation

> US National Institutes of Health, RePORTER application 11396315, A type II hybrid implementation-effectiveness study of BECOME (BEhavioral Community-based COmbined Intervention for MEntal Health and Noncommunicable Diseases) delivered by community health workers (5R01MH133231-04). Retrieved via AI Analytics 2026-06-26 from https://api.ai-analytics.org/grant/nih/11396315. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*