Center Advisors, Emerging Technologies & Data Analytics Core

Tobias Kowatsch, PhD

Associate Professor for Digital Health Interventions, University of Zurich (UZH); Director, School of Medicine, University of St. Gallen (HSG); and Scientific Director, Centre for Digital Health Interventions, UZH, HSG and ETH Zurich

Digital Health Interventions; Digital Clinical Pathways; Digital Coaching; Biomarkers; Design Science Research


Tobias Kowatsch, PhD
Associate Professor for Digital Health Interventions, University of Zurich (UZH); Director, School of Medicine, University of St. Gallen (HSG); and Scientific Director, Centre for Digital Health Interventions, UZH, HSG and ETH Zurich

Selected Publications
  • Jacobson N, Kowatsch T, Marsch, LA, editors. Digital therapeutics for mental health and addiction: The state of the science and vision for the future. 1st edition. Academic Press; 2022 September 27. Paperback ISBN: 9780323900454.
  • Schlieter H, Marsch LA, Whitehouse D, Otto L, Londral AR, Teepe GW, Benedict M, Ollier J, Ulmer T, Gasser N, Ultsch S, Wollschlaeger B, Kowatsch T. Scale-up of digital innovations in health care: Expert commentary on enablers and barriers. J Med Internet Res. 2022 Mar 11;24(3):e24582. doi: 10.2196/24582. PMID: 35275065.
  • Nißen MK, Selimi D, Janssen A, Rodríguez Cardona D, Breitner, MH, Kowatsch T. & von Wangenheim F. See you soon again, chatbot? A design taxonomy to characterize user-chatbot relationships with different time horizons. Computers in Human Behavior. 2022 Feb; 127:10704.
  • Keller R, Hartmann S, Teepe GW, Lohse KM, Alattas A, Tudor Car L, Müller-Riemenschneider F, von Wangenheim F, Mair JL, Kowatsch T. Digital behavior change interventions for the prevention and management of type 2 diabetes: Systematic market analysis. J Med Internet Res. 2022 Jan 7;24(1):e33348. doi: 10.2196/33348. PMID: 34994693; PMCID: PMC8783286.
  • Bérubé C, Kovacs ZF, Fleisch E, Kowatsch T. Reliability of commercial voice assistants' responses to health-related questions in noncommunicable disease management: Factorial experiment assessing response rate and source of information. J Med Internet Res. 2021 Dec 20;23(12):e32161. doi: 10.2196/32161. PMID: 34932003; PMCID: PMC8726026.
  • Teepe GW, Da Fonseca A, Kleim B, Jacobson NC, Salamanca Sanabria A, Tudor Car L, Fleisch E, Kowatsch T. Just-in-time adaptive mechanisms of popular mobile apps for individuals with depression: Systematic app search and literature review. J Med Internet Res. 2021 Sep 28;23(9):e29412. doi: 10.2196/29412. PMID: 34309569.
  • Lukic Y, Klein S, Brügger V, Keller O, Fleisch E, Kowatsch T. The impact of a gameful breathing training visualization on intrinsic experiential value, perceived effectiveness, and engagement intentions: Between-subject online experiment. JMIR Serious Games. 08/08/2021:22803.
  • Stasinaki A, Büchter D, Shih CI, Heldt K, Güsewell S, Brogle B, Farpour-Lambert N, Kowatsch T, l'Allemand D. Effects of a novel mobile health intervention compared to a multi-component behaviour changing program on body mass index, physical capacities and stress parameters in adolescents with obesity: A randomized controlled trial. BMC Pediatr. 2021 Jul 9;21(1):308. doi: 10.1186/s12887-021-02781-2. PMID: 34243738; PMCID: PMC8266630.
  • Mishra V, Künzler F, Kramer JN, Fleisch E, Kowatsch T, Kotz D. Detecting receptivity for mHealth interventions in the natural environment. Proc ACM Interact Mob Wearable Ubiquitous Technol. 2021 Jun;5(2):74. doi: 10.1145/3463492. PMID: 34926979; PMCID: PMC8680205.
  • Gross C, Schachner T, Hasl A, Kohlbrenner D, Clarenbach CF, Wangenheim FV, Kowatsch T. Personalization of conversational agent-patient interaction styles for chronic disease management: Two consecutive cross-sectional questionnaire studies. J Med Internet Res. 2021 May 26;23(5):e26643. doi: 10.2196/26643. PMID: 33913814; PMCID: PMC8190651.
  • Mönninghoff A, Kramer JN, Hess AJ, Ismailova K, Teepe GW, Tudor Car L, Müller-Riemenschneider F, Kowatsch T. Long-term effectiveness of mHealth physical activity interventions: Systematic review and meta-analysis of randomized controlled trials. J Med Internet Res. 2021 Apr 30;23(4):e26699. doi: 10.2196/26699. PMID: 33811021; PMCID: PMC8122296.
  • Banholzer N, Feuerriegel S, Fleisch E, Bauer GF, Kowatsch T. Computer mouse movements as an indicator of work stress: Longitudinal observational field study. J Med Internet Res. 2021 Apr 2;23(4):e27121. doi: 10.2196/27121. PMID: 33632675; PMCID: PMC8052599.
  • Bérubé C, Schachner T, Keller R, Fleisch E, V Wangenheim F, Barata F, Kowatsch T. Voice-based conversational agents for the prevention and management of chronic and mental health conditions: Systematic literature review. J Med Internet Res. 2021 Mar 29;23(3):e25933. doi: 10.2196/25933. PMID: 33658174; PMCID: PMC8042539.
  • Stanger C, Kowatsch T, Xie H, Nahum-Shani I, Lim-Liberty F, Anderson M, Santhanam P, Kaden S, Rosenberg B. A digital health intervention (SweetGoals) for young adults with type 1 diabetes: Protocol for a factorial randomized trial. JMIR Res Protoc. 2021 Feb 23;10(2):e27109. doi: 10.2196/27109. PMID: 33620330.
  • Stieger M, Flückiger C, Rüegger D, Kowatsch T, Roberts BW, Allemand M. Changing personality traits with the help of a digital personality change intervention. Proc Natl Acad Sci U S A. 2021 Feb 23;118(8):e2017548118. doi: 10.1073/pnas.2017548118. PMID: 33558417; PMCID: PMC7923371.
  • Kowatsch T, Lohse KM, Erb V, Schittenhelm L, Galliker H, Lehner R, Huang EM. Hybrid ubiquitous coaching with a novel combination of mobile and holographic conversational agents targeting adherence to home exercises: Four design and evaluation studies. J Med Internet Res. 2021 Feb 22;23(2):e23612. doi: 10.2196/23612. PMID: 33461957; PMCID: PMC7939948.
  • Kowatsch T, Schachner T, Harperink S, Barata F, Dittler U, Xiao G, Stanger C, V Wangenheim F, Fleisch E, Oswald H, Möller A. Conversational Agents as mediating social actors in chronic disease management involving health care professionals, patients, and family members: Multisite single-arm feasibility study. J Med Internet Res. 2021 Feb 17;23(2):e25060. doi: 10.2196/25060. PMID: 33484114; PMCID: PMC7929753.
  • Lukic YX, Shih CI, Hernandez Reguera A, Cotti A, Fleisch E, Kowatsch T. Physiological responses and user feedback on a gameful breathing training app: Within-subject experiment. JMIR Serious Games. 2021 Feb 8;9(1):e22802. doi: 10.2196/22802. PMID: 33555264; PMCID: PMC7899808.
  • Schachner T, Gross C, Hasl A, V Wangenheim F, Kowatsch T. Deliberative and paternalistic interaction styles for conversational agents in digital health: Procedure and validation through a web-based experiment. J Med Internet Res. 2021 Jan 29;23(1):e22919. doi: 10.2196/22919. PMID: 33512328; PMCID: PMC7880814.
  • Tinschert P, Rassouli F, Barata F, Steurer-Stey C, Fleisch E, Puhan MA, Kowatsch T, Brutsche MH. Nocturnal cough and sleep quality to assess asthma control and predict attacks. J Asthma Allergy. 2020 Dec 14;13:669-678. doi: 10.2147/JAA.S278155. PMID: 33363391; PMCID: PMC7754262.
  • Rassouli F, Tinschert P, Barata F, Steurer-Stey C, Fleisch E, Puhan MA, Baty F, Kowatsch T, Brutsche MH. Characteristics of asthma-related nocturnal cough: A potential new digital biomarker. J Asthma Allergy. 2020 Dec 3;13:649-657. doi: 10.2147/JAA.S278119. PMID: 33299332; PMCID: PMC7721277.
  • Rüegger D, Stieger M, Nißen MK, Allemand M, Fleisch E, Kowatsch T. How are personality states associated with smartphone data? European Journal of Personality 34(5) Special Issue: Behavioral personality science in the age of big data, 687-713 10.1002/per.2309.
  • Tudor Car L, Dhinagaran DA, Kyaw BM, Kowatsch T, Joty S, Theng YL, Atun R. Conversational agents in health care: Scoping review and conceptual analysis. J Med Internet Res. 2020 Aug 7;22(8):e17158. doi: 10.2196/17158. PMID: 32763886; PMCID: PMC7442948.
  • Barata F, Tinschert P, Rassouli F, Steurer-Stey C, Fleisch E, Puhan MA, Brutsche M, Kotz D, Kowatsch T. Automatic recognition, segmentation, and sex assignment of nocturnal asthmatic coughs and cough epochs in smartphone audio recordings: Observational field study. J Med Internet Res. 2020 Jul 14;22(7):e18082. doi: 10.2196/18082. PMID: 32459641; PMCID: PMC7388043.
  • Haug S, Paz Castro R, Scholz U, Kowatsch T, Schaub MP, Radtke T. Assessment of the efficacy of a mobile phone-delivered just-in-time planning intervention to reduce alcohol use in adolescents: Randomized controlled crossover trial. JMIR Mhealth Uhealth. 2020 May 26;8(5):e16937. doi: 10.2196/16937. PMID: 32452818; PMCID: PMC7284414.
  • Hauser-Ulrich S, Künzli H, Meier-Peterhans D, Kowatsch T. A smartphone-based health care chatbot to promote Self-Management of Chronic Pain (SELMA): Pilot randomized controlled trial. JMIR Mhealth Uhealth. 2020 Apr 3;8(4):e15806. doi: 10.2196/15806. PMID: 32242820; PMCID: PMC7165314.
  • Kramer JN, Künzler F, Mishra V, Smith SN, Kotz D, Scholz U, Fleisch E, Kowatsch T. Which components of a smartphone walking app help users to reach personalized step goals? Results from an optimization trial. Ann Behav Med. 2020 Jun 12;54(7):518-528. doi: 10.1093/abm/kaaa002. PMID: 32182353; PMCID: PMC7291330.
  • Shih I, Tomita N, Lukic Y, Hernández Á, Fleisch E, Kowatsch T. Breeze: Smartphone-based acoustic real-time detection of breathing phases for a gamified biofeedback breathing training. Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies (IMWUT). 2019 Dec 11; 3(4): Paper 152 10.1145/3369835.
  • Künzler F, Mishra V, Kramer JK, Kotz D, Fleisch E, Kowatsch T. Exploring the state-of-receptivity for mHealth interventions. Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies (IMWUT) (Ubicomp), 3(4)#140, December 2019. doi:10.1145/3369805.
  • Kowatsch T, Otto L, Harperink S, Cotti A, Schlieter H. A design and evaluation framework for digital health Interventions. it – Information Technology. 2019 Nov 20; 61(5-6): 253-263.
  • Kramer JN, Tinschert P, Scholz U, Fleisch E, Kowatsch T. A cluster-randomized trial on small incentives to promote physical activity. Am J Prev Med. 2019 Feb;56(2):e45-e54. doi: 10.1016/j.amepre.2018.09.018. PMID: 30553693.
  • Tinschert P, Rassouli F, Barata F, Steurer-Stey C, Fleisch E, Puhan MA, Brutsche M, Kowatsch T. Prevalence of nocturnal cough in asthma and its potential as a marker for asthma control (MAC) in combination with sleep quality: Protocol of a smartphone-based, multicentre, longitudinal observational study with two stages. BMJ Open. 2019 Jan 7;9(1):e026323. doi: 10.1136/bmjopen-2018-026323. PMID: 30617104; PMCID: PMC6326321.
  • Presset B, Kramer J, Kowatsch T, Ohl F. The social meaning of steps: User reception of a mobile health intervention on physical activity. Critical Public Health. 2018 Oct 22.
  • Stieger M, Nißen M, Rüegger D, Kowatsch T, Flückiger C, Allemand M. PEACH, a smartphone- and conversational agent-based coaching intervention for intentional personality change: study protocol of a randomized, wait-list controlled trial. BMC Psychol. 2018 Sep 4;6(1):43. doi: 10.1186/s40359-018-0257-9. PMID: 30180880; PMCID: PMC6123904.
  • Paz Castro R, Haug S, Kowatsch T, Filler A, Schaub MP. Moderators of outcome in a technology-based intervention to prevent and reduce problem drinking among adolescents. Addict Behav. 2017 Sep;72:64-71. doi: 10.1016/j.addbeh.2017.03.013. PMID: 28371696.
  • Kramer JN, Kowatsch T. Using feedback to promote physical activity: The role of the feedback sign. J Med Internet Res. 2017 Jun 2;19(6):e192. doi: 10.2196/jmir.7012. PMID: 28576757; PMCID: PMC5473947.
  • Wahle F, Bollhalder L, Kowatsch T, Fleisch E. Toward the design of evidence-based mental health information systems for people with depression: A systematic literature review and meta-analysis. J Med Internet Res. 2017 May 31;19(5):e191. doi: 10.2196/jmir.7381. PMID: 28566267; PMCID: PMC5471345.
  • Haug S, Paz Castro R, Kowatsch T, Filler A, Dey M, Schaub MP. Efficacy of a web- and text messaging-based intervention to reduce problem drinking in adolescents: Results of a cluster-randomized controlled trial. J Consult Clin Psychol. 2017 Feb;85(2):147-159. doi: 10.1037/ccp0000138. PMID: 27606700.
  • Tinschert P, Barata F, Kowatsch T. Enhancing asthma control through it: Design, implementation and planned evaluation of the mobile asthma companion. In Leimeister JM, Brenner W. (Hrsg.): Proceedings der 13th International Conference on Wirtschaftsinformatik (WI 2017), St. Gallen, 1291-1294.
  • Kowatsch T, Volland D, Shih I, Rüegger D, Künzler F, Barata F, Filler A, Büchter D, Brogle B, Heldt K, Gindrat P, Farpour-Lambert N, l’Allemand D. Design and evaluation of a mobile chat app for the open source behavioral health intervention platform MobileCoach. 12th International Conference on Design Science Research in Information Systems and Technology (DESRIST 2017), Karlsruhe, Germany.
  • Wahle F, Kowatsch T, Fleisch E, Rufer M, Weidt S. Mobile sensing and support for people with depression: A pilot trial in the wild. JMIR Mhealth Uhealth. 2016 Sep 21;4(3):e111. doi: 10.2196/mhealth.5960. PMID: 27655245; PMCID: PMC5052463.
  • Haug S, Castro RP, Kwon M, Filler A, Kowatsch T, Schaub MP. Smartphone use and smartphone addiction among young people in Switzerland. J Behav Addict. 2015 Dec;4(4):299-307. doi: 10.1556/2006.4.2015.037. PMID: 26690625; PMCID: PMC4712764.
  • Kehr F, Kowatsch T, Wentzel D, Fleisch E. Blissfully ignorant: The effects of general privacy concerns, general institutional trust, and affect in the privacy calculus. Information Systems Journal. 2015 Oct 9; 25(6): 607-635.
  • Filler A, Kowatsch T, Haug S, Wahle F, Staake T, Fleisch E. MobileCoach: A novel open source platform for the design of evidence-based, scalable and low-cost behavioral health interventions. 14th Annual Wireless Telecommunications Symposium (WTS 2015), USA, New York.
  • Kowatsch T, Maass W, Pletikosa Cvijikj I, Xu R, Büchter D, Brogle B, Dintheer A, Wiegand D, Durrer D, Schutz Y, l’Allemand D.  Design of a health information system enhancing the performance of obesity expert and children teams. 22nd European Conference on Information Systems (ECIS), 2014. Tel Aviv, Israel.
  • Wahle F, Kowatsch T. Towards the design of evidence-based mental health information systems: A preliminary literature review. 35th International Conference on Information Systems (ICIS), 2014. Auckland, New Zealand.