Discussion
psychotic disorder
Limited eHealth-supported lifestyle interventions are available for clients with SMI, tailored to their specific needs and characteristics. However, given the overall burden of poor physical health on clients with SMI [A strength of this study is its pragmatic design. The study will be conducted in mental health teams and implemented as part of essential care. In this way clients, treatments, and procedures resemble daily clinical practice. This increases the generalisability of the study outcomes. Another way the generalisability is enhanced is by including clients with SMI who receive care within different treatment settings. This limits the treatment setting as influencing factor on effectiveness and implementation. An additional strength is the quality of the GILL eHealth intervention. GILL eHealth is the result of a long-term development trajectory and is adapted to the preferences of clients and nurses. The intervention is based on current national and international guidelines [The GILL eHealth intervention does not allow for blinding of participants and nurses for the study. However, this reflects the daily practice and matches the pragmatic study design. Most important is to prevent contamination between the two study conditions – therefore the cluster-randomised design will be applied, in which the nurses working in the usual care teams will not receive training.The underlying reasons that stall the implementation of systematic somatic screening and lifestyle interventions could become a limitation in this study. Currently only 17% of clients with a psychotic disorder in the Netherlands receive systematic somatic screening [Overall, this study will yield important and relevant information on the use of eHealth modules for improving physical health and lifestyle behaviours. The GILL eHealth module can become a clinically relevant tool when proven effective. This study will also provide insight into the barriers and facilitators for effective implementation. The first study results are expected in 2025.