Barriers to consumer engagement with digital mental health interventions: Developing a robust measure.

The use of digital mental health (DMH) interventions in routine care-and the barriers that limit their uptake-is well documented.However, recent work has highlighted a lack of robust measures to identify and quantify these barriers.The present study aimed to develop a reliable and valid measure of barriers associated with using DMH interventions by consumers.Informed by literature review and organized using the Consolidated Framework for Implementation Research, 112 items were developed.These items underwent iterative refinement through author review, expert consultation, and feedback from potential end users, resulting in a 42-item pilot version of the scale.Data were collected from 420 participants (406 analyzed) to conduct principal component analysis and confirmatory factor analysis.Principal component analysis with oblique rotation revealed a stable six-factor structure.Confirmatory factor analysis results supported this structure, yielding strong model fit indices (comparative fit index = 0.92, Tucker-Lewis index = 0.91, incremental fit index = 0.93, root-meansquare error of approximation = 0.06, standardized root-mean-square residual = 0.06).The six identified components were DMH Knowledge, DMH Characteristics, Individual Symptomatology, Help-Seeking Readiness, Access Barriers, and Privacy Concerns.The scale demonstrated excellent internal consistency and strong test-retest reliability.It also showed robust convergent, divergent, and discriminant validity.The Measure of Barriers to DMH Use-Consumer is a reliable and valid measure of the barriers to DMH engagement by consumers.Developed in line with best practice guidelines, the Measure of Barriers to DMH Use-Consumer offers a systematic approach to identifying barriers and has potential utility for policymakers, researchers, mental health organizations, and practitioners seeking to enhance consumer uptake of DMH interventions. Public Significance StatementWe developed a new, reliable and valid tool to identify the obstacles that stop people from using digital mental health interventions.These findings can help clinicians, policymakers, and community leaders create targeted strategies to improve access to digitally delivered mental health care, ultimately improving access to mental health interventions.