# BASIC

> **NIH NIH R01** · DUKE UNIVERSITY · 2020 · $659,844

## Abstract

Eighty percent of the world’s population lives in low and middle income countries (LMIC) with few mental health
resources, resulting in a substantial mental health treatment gap. Growing evidence indicates that evidence-
based mental health treatments can be delivered in LMIC using a task-sharing approach, in which non-
professionals deliver care under supervision. Very limited research, however, focuses on how to embed,
support, and effectively deliver these treatments within existing, government-supported systems in which they
could be scaled up to population-level. With LMIC governments typically spending <2% of their national budget
on mental health, innovative and low-cost options are needed for intervention delivery and for implementation
support. Building and Sustaining Interventions for Children (BASIC): Task-sharing mental health care in
low-resource settings builds on our 15-year history of collaborations with research partners in Kenya, prior
NIH-funded work that identified mental health needs of orphaned children in LMIC, and iterative and
collaborative intervention adaptation and testing using a task-sharing approach, to address these needs. In
BASIC, we test the implementation of Trauma-focused Cognitive Behavioral Therapy (TF-CBT), delivered via
task-sharing, in two governmental sectors prioritized by our Kenyan partners as potential options for scale up—
Education and Health Extension. The recent devolvement of the Kenyan government (leading to more local
decision-making), the launch of a National Mental Health Policy, and our Kenyan partners’ empowerment work
building enthusiasm for TF-CBT are converging to create a local climate in which BASIC could become part of
the county plan, if evidence-based guidance for implementation, using mostly existing resources, existed. We
test mental health treatment delivery in Education (via teacher delivery) and Health Extension (via community
health volunteers) with the goal of identifying implementation practices and policies (IPPs) that explain
implementation outcomes. This stepped wedge cluster randomized trial includes 40 schools and the 40
surrounding villages (120 lay counselors in each) who provide TF-CBT to 1,280 youth. We use a novel
method, qualitative comparative analyses (QCA), that holds potential for substantially advancing the field of
implementation science. QCA leverages the rigor of quantitative approaches and the detail of qualitative
approaches, and allows for complex causality and equifinality (i.e., an outcome can be reached by multiple
means). Study aims are: 1) Identify actionable IPPs that predict adoption (delivery) and fidelity (high-
quality delivery) after 10 sites in sector implement TF-CBT. Use identified IPPs to (Aim 1a) guide
implementation planning support for subsequent sites and to (Aim 1b) generate testable hypotheses about
IPPs as causal mechanisms; 2) Test mechanisms of implementation success in both sectors; and 3) Test
TF-CBT effectiveness (i.e., menta...

## Key facts

- **NIH application ID:** 9964902
- **Project number:** 5R01MH112633-04
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Shannon Dorsey
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $659,844
- **Award type:** 5
- **Project period:** 2017-08-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9964902

## Citation

> US National Institutes of Health, RePORTER application 9964902, BASIC (5R01MH112633-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9964902. Licensed CC0.

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