PhD Position (100%) Agentic Adherence Promotion Interventions in Pediatric Digital Biomarker Studies

We offer a fully funded PhD Position (100%, 4 years) at the School of Medicine and Institute of Technology Management, University of St. Gallen (HSG) on Agentic Interventions for the Promotion of Adherence to Digital Biomarker Studies in Children and Adolescents.

The PhD is in Management and will be pursued in the Behavioral Science Track at HSG.

Project Context

Digital biomarker studies with children and adolescents, incl. family members, increasingly rely on smartphones, wearables, and brief in-the-moment self-reports to capture real-world signals such as activity, sleep, stress, or symptoms. However, many studies struggle with sustained participation and data completeness, especially when study protocols extend over weeks or months and when families must coordinate devices, appointments, and daily routines.

This PhD project explores how agentic interventions (for example LLM-based, adaptive, context-aware conversational agent/chatbot-delivered messages) can ethically and effectively promote adherence while minimizing burden and strengthening trust with minors and their caregivers.

One Core Use Case: SNF Project KIND

A central applied setting for this PhD will be the accepted SNF project KIND (Kinder und Neuropathie bei Diabetes), which investigates the link between type 1 diabetes management and nerve vitality in children and adolescents. The project combines clinical measures (for example neurophysiology and ultrasound) with free-living digital monitoring (wearable-based physical activity, sleep, heart rate variability, plus CGM-derived metrics) over repeated periods and follow-ups.

In the KIND study design, wearables are introduced and explained to participants during an extra visit, including the possibility of home visits, and lifestyle tracking is conducted for several weeks around clinical assessment time points.

Within this real-world, high-impact context, the PhD candidate will develop and evaluate agentic strategies that help children, adolescents, and families to:

successfully onboard into the study protocol (devices, apps, expectations)
sustain engagement over repeated measurement windows
handle disruptions (device issues, sports restrictions, routine changes)
reduce dropouts while respecting autonomy, consent/assent, and family dynamics

Your PhD Project

Desk Research and Evidence Synthesis

Conduct desk research on adherence challenges and engagement strategies in pediatric digital health research
Lead a systematic review of factors influencing adherence to digital biomarker study protocols, with a special focus on children and adolescents

Designing and Evaluating Agentic Interventions

Translate behavioral theory and empirical evidence into practical intervention concepts (for example tailored prompts, adaptive goal setting, supportive micro-interactions, caregiver-aware support)
Define design principles that balance adherence gains with burden, fairness, privacy, transparency, and age-appropriateness
Build prototypes with PRECIOUS and collaborate on integration into study workflows (in coordination with the broader project team)

Field Research with Clinical and Family Partners

Work closely with clinical partners at the Children’s Hospital of Eastern Switzerland and associated care settings
Engage with families of children and adolescents with type 1 diabetes, including interviews and home visits where appropriate, to co-design, test, and refine adherence support strategies

Rigor and Publication

Plan and execute robust evaluations (for example longitudinal studies, experiments, micro-randomized approaches, or A/B tests where feasible)
Publish in strong international outlets spanning behavioral science, information systems, digital health, and technology management

Your Academic Environment

Degree: PhD in Management (Behavioral Science)
Institution: University of St. Gallen (HSG)
Supervision:
- Prof. Dr. Tobias Kowatsch, School of Medicine HSG & Institute for Implementation Science in Health Care, University of Zurich & D-MTEC, ETH Zurich
- Prof. Dr. Felix Wortmann, Institute of Technology Management HSG & D-MTEC, ETH Zurich
Clinical collaboration for the KIND use case: Children’s Hospital of Eastern Switzerland and diabetes care partners, with an interdisciplinary team spanning pediatric neurology, diabetology, and digital biomarkers.

Candidate Profile

Required

Master’s degree in behavioral science, technology management, business informatics, computer science, machine learning, or a related field
Strong interest in behavior change, digital health, and human-centered technology
Excellent quantitative skills (experiments, longitudinal analysis, causal inference, or applied ML, LLM-based agentic interventions), with openness to mixed-methods work
Strong German language skills (needed for close collaboration with clinical partners and families), plus very good English for academic publishing
Motivation to work in applied clinical contexts and to engage directly with families (including interviews and home visits)

Desired

Experience with digital health studies, wearables, mobile sensing, or conversational AI and user interfaces
Experience designing interventions, services, or user journeys in sensitive contexts (minors, healthcare, family settings)
Familiarity with research ethics and data protection in human-subjects research

What We Offer

Fully funded 4-year PhD position, starting April-June 2026
Competitive Swiss doctoral salary
A highly interdisciplinary, impact-oriented environment at HSG with strong clinical collaboration
Access to a concrete, high-value field setting through the SNF project KIND
Strong support for publishing, conference participation, and career development

Application

Please submit one single PDF document containing the following items in this exact order no later than 15th of February 2026 to tobias.kowatsch@unisg.ch:

Cover letter in German, addressed to

Prof. Dr. Tobias Kowatsch and Prof. Dr. Felix Wortmann

motivating why you want to (a) pursue a PhD at HSG and (b) work on this specific topic
Curriculum Vitae (CV) in English
Transcript of records / overview of grades
At least two letters of recommendation
Written reflections on prediction and prevention of non-adherence in pediatric digital biomarker studies ideally referencing how you would learn from and contribute to the KIND use case (see also the related work below):

a) One quantitative reflection on how to prevent non-adherence in pediatric digital biomarker studies (minimum 1 page), and

b) One qualitative reflection on how to predict non-adherence in pediatric digital biomarker studies (minimum 1 page)

Join Us

This PhD position offers a rare opportunity to combine rigorous academic research with real-world impact at national and international scale. You will help redefine how to predict and prevent non-adherence in pediatric digital biomarker studies. We look forward to your application.

Related Work

Applicants are encouraged to consult the following related work for inspiration when preparing their application:

Kelders, et al. (2026) Engagement in Digital Health Interventions: Open Questions for Research and Design, Proc. ACM Conference on Human Factors in Computing Systems (CHI 2026), Barcelona, Spain 13 – 17 April 2026, 10.1145/3772363.3778762
Jakob R, Harperink S, Rudolf AM, Fleisch E, Haug S, Mair JL, Salamanca-Sanabria A, Kowatsch T. (2022) Factors Influencing Adherence to mHealth Apps for Prevention or Management of Noncommunicable Diseases: Systematic Review. J Med Internet Res 2022;24(5):e35371. 10.2196/35371
Paz Castro R, Haug S, Debelak R, Jakob R, Kowatsch T, Schaub M. (2022) Engagement With a Mobile Phone–Based Life Skills Intervention for Adolescents and Its Association With Participant Characteristics and Outcomes: Tree-Based Analysis. J Med Internet Res 2022;24(1):e28638, 10.2196/28638
Jakob R. Narauskas J. Fleisch E. König L.M. Kowatsch T. (2024) Factors associated with adherence to a public mobile nutritional health intervention: retrospective cohort study, Computers in Human Behavior Reports 15(100445), 10.1016/j.chbr.2024.100445
Jakob R. Lepper N. Fleisch E. Kowatsch T. (2024) Predicting early user churn in a public digital weight loss intervention, CHI ’24: Proceedings of the CHI Conference on Human Factors in Computing Systems, May 2024, Article 994, 10.1145/3613904.3642321
Achilles M. R. Anderson M. Li S. H. Subotic-Kerry M. Parker B. & O’Dea B. (2020) Adherence to e-mental health among youth: Considerations for intervention development and research design. Digital Health, 21(6), 10.1177/2055207620926064
Baumel A, Muench F, Edan S, Kane JM (2019) Objective User Engagement With Mental Health Apps: Systematic Search and Panel-Based Usage Analysis, J Med Internet Res 2019;21(9):e14567, 10.2196/14567
Sieverink F Kelders SM van Gemert-Pijnen JE (2017) Clarifying the Concept of Adherence to eHealth Technology: Systematic Review on When Usage Becomes Adherence, J Med Internet Res 2017;19(12):e402, 10.2196/jmir.8578