Table 1 Five important features of the multidimensional lifestyle intervention using a web tool in the LION study

1

Patients’ readiness for behaviour change is not a prerequisite for starting the intervention. Nurses encourage behaviour change by making use of the stages-of-change of the transtheoretical model [17] and motivational interviewing [16].

2

Patient-centeredness: patients decide if and what behaviour he/she wants to change, creates his/her own lifestyle plan with realistic goals and support. The tool can also be used by patients themselves to enhance self-management.

3

Because diet and physical activity are key components of a healthy lifestyle, these components are combined with behavioural change counselling; for an intervention to be effective, these three ingredients should be included [11].

4

Active support of the patient’s family and friends, incorporated in the lifestyle plan.

5

Nurses are trained to not only support patients in their behaviour change but also work behind the scenes to create a healthier environment: organise accessible exercise opportunities, raise team support for a healthier lifestyle in patients and share up to date lifestyle knowledge with the team, and raise awareness among other health care professionals (e.g. GP’s) of the increased cardiovascular risk of most SMI patients.