Strengths and limitations
depression, anxiety
RECRUITMENT
A strength of this study is that patients were recruited in the everyday setting of two different primary care clinics, implying that results are likely to generalize well to similar routine care contexts. Another strength is that there were few exclusion criteria, which means that the majority of primary care patients scheduled for in-house mental health assessment were eligible to participate. For example, there was no exclusion of patients reporting severe anxiety or depression symptoms, and there was no upper age limit. A strength was also the embedded recruitment trial, which provided preliminary data for a possible future RCT.Limitations include the fact that additional information about the patients was not collected; e.g., socioeconomic variables and medication, because the study was planned not to interfere too much with routine care. A second limitation is that the inclusion rate was very slow in the first clinic and that the patient population may therefore not be representative. In addition, the LBQ lifestyle questionnaire, used in standard care in the region where the study was conducted, has not been formally validated although it is used as part of the digital medical record system in the Stockholm region where the study was conducted. Also, a drawback of the digital platform chosen was the limited possibility for systematically collecting information about usage of the intervention. Finally, the lack of long-term follow-up assessments could be construed as a limitation, but the value of long-term assessment is questionable given that the study was a pilot trial.