The study design for this trial has several advantages. First, by using regular ROM screenings and structurally inviting all patients with screening outcomes indicating at least one cardiometabolic risk factor, patient selection bias is minimal. Second, the intervention is feasible for a large number of patients (e.g. also unmotivated patients are eligible, implementation during regular care visits), leading to a large and highly representative study sample to be included. Third, follow-up of less motivated patients is feasible because of the routine ROM screenings, which will be performed routinely in all patients. Fourth, data collection is based on existing Routine Outcome Monitoring screenings infrastructures, which has several advantages: ROM nurses are well trained, baseline and follow-up measures are conducted by the same nurse, and additional time and costs of patients, nurses and researchers are limited. The ROM data collection covers a wide scope of measures, i.e. several physical measures and multiple psychosocial measures and, for this trial, only had to be extended with cost-effectiveness measures. Finally, the pragmatic character of the study, in which MH nurses carry out the intervention in hectic real word health care settings, will result in realistic and achievable intervention outcomes, representing outcomes with high external validity [8, 13].