Tobias Kowatsch

Tobias Kowatsch

Title

Prof. Dr.

Last Name

Kowatsch

First name

Tobias

Email

tobias.kowatsch@unisg.ch

ORCID

0000-0001-5939-4145

Phone

+41 71 224 7244

Homepage

www.c4dhi.org

Now showing 1 - 10 of 258

Proactive behavior in voice assistants: A systematic review and conceptual model

( 2024)
Caterina Bérubé
;
Marcia Nissen
;
Rasita Vinay
;
Alexa Geiger
;
Tobias Budig
;
Aashish Bhandari
;
Catherine Rachel Pe Benito
;
Nathan Ibarcena
;
Olivia Pistolese
;
Pan Li
;
Abdullah Bin Sawad
;
Elgar Fleisch
;
Christoph Stettler
;
Bronwyn Hemsley
;
Shlomo Berkovsky
;
Tobias Kowatsch
;
A. Baki Kocaballi

Voice assistants (VAs) are increasingly integrated into everyday activities and tasks, raising novel challenges for users and researchers. One emergent research direction concerns proactive VAs, who can initiate interaction without direct user input, offering unique benefits including efficiency and natural interaction. Yet, there is a lack of review studies synthesizing the current knowledge on how proactive behavior has been implemented in VAs and under what conditions proactivity has been found more or less suitable. To this end, we conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We searched for articles in the ACM Digital Library, IEEExplore, and PubMed, and included primary research studies reporting user evaluations of proactive VAs, resulting in 21 studies included for analysis. First, to characterize proactive behavior in VAs we developed a novel conceptual model encompassing context, initiation, and action components: Activity/status emerged as the primary contextual element, direct initiation was more common than indirect initiation, and suggestions were the primary action observed. Second, proactive behavior in VAs was predominantly explored in domestic and in-vehicle contexts, with only safety-critical and emergency situations demonstrating clear benefits for proactivity, compared to mixed findings for other scenarios. The paper concludes with a summary of the prevailing knowledge gaps and potential research avenues.

Type: journal article

Journal: Computers in Human Behavior Reports

URL: https://www.sciencedirect.com/science/article/pii/S2451958824000447

DOI: 10.1016/j.chbr.2024.100411

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/119758
Impact of digital assistive technologies on the quality of life for people with dementia: a scoping review

( 2024)
Charlotte Schneider
;
Marcia Nissen
;
Tobias Kowatsch
;
Rasita Vinay

Background Digital assistive technologies (DATs) have emerged as promising tools to support the daily life of people with dementia (PWD). Current research tends to concentrate either on specific categories of DATs or provide a generic view. Therefore, it is of essence to provide a review of different kinds of DATs and how they contribute to improving quality of life (QOL) for PWD. Design Scoping review using the framework proposed by Arksey and O’Malley and recommendations from Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Data sources Cochrane, Embase, PubMed, Scopus and Web of Science (January 2013 to May 2023). Eligibility criteria for selecting studies Completed scientific literature with a primary focus on DATs for PWD, perspectives of caregivers, family members or healthcare workers in relation to a PWD, people living in diverse settings and all severities of dementia. Data extraction and synthesis Screening and data extraction were conducted, followed by quantitative and qualitative analyses using thematic analysis principles and Digital Therapeutics Alliance categories for DAT grouping. Results The literature search identified 6083 records, with 1056 duplicates. After screening, 4560 full texts were excluded, yielding 122 studies of different designs. The DATs were categorised into digital therapeutics (n=109), patient monitoring (n=30), digital diagnostics (n=2), care support (n=2) and health system clinical software (n=1). These categories were identified to impact various aspects of QOL: preserving autonomy, engagement, and social interaction, health monitoring and promotion, improving activities of daily living, improving cognition, maintaining dignity, managing behavioural and psychological symptoms of dementia and safety/surveillance. Conclusions Various DATs offer extensive support, elevating the QOL of PWD. Digital therapeutics are predominantly used for ageing-in-place and independent living through assistance with daily tasks. Future research should focus on less-represented digital health technology categories, such as care support, health & wellness or software solutions. Observing ongoing DAT developments and their long-term effects on QOL remains essential.

Type: journal article

Journal: BMJ Open

Volume: 14 (2)

URL: https://bmjopen.bmj.com/content/14/2/e080545

DOI: https://doi.org/10.1136/bmjopen-2023-080545

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/119479
Self-efficacy effects on symptom experiences in daily life and early treatment success in anxiety patients

( 2024)
Christina Paersch
;
Dominique Recher
;
Ava Schulz
;
Heininger Mirka
;
Barbara Schlup
;
Florian Künzler
;
Stephanie Homan
;
Tobias Kowatsch
;
Aaron Fisher
;
Andrea B. Horn
;
Birgit Kleim

Self-efficacy is a key construct in behavioral science affecting mental health and psychopathology. Here, we expand on previously demonstrated between-persons self-efficacy effects. We prompted 66 patients five times daily for 14 days before starting cognitive behavioral therapy (CBT) to provide avoidance, hope, and perceived psychophysiological-arousal ratings. Multilevel logistic regression analyses confirmed self-efficacy’s significant effects on avoidance in daily life (odds ratio [OR] = 0.53, 95% confidence interval [CI] = [0.34, 0.84], p = .008) and interaction effects with anxiety in predicting perceived psychophysiological arousal (OR = 0.79, 95% CI = [0.62, 1.00], p = .046) and hope (OR = 1.21, 95% CI = [1.03, 1.42], p = .02). More self-efficacious patients also reported greater anxiety-symptom reduction early in treatment. Our findings assign a key role to self-efficacy for daily anxiety-symptom experiences and for early CBT success. Self-efficacy interventions delivered in patients’ daily lives could help improve treatment outcome.

Type: journal article

Journal: Clinical Psychological Science

DOI: 10.1177/21677026231205

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/117883
Less stick more carrot? Increasing the uptake of deposit contract financial incentives for physical activity: A randomized controlled trial

( 2024)
David R. de Buisonjé
;
Thomas Reijnders
;
Talia R. Cohen Rodrigues
;
Prabhakaran Santhanam
;
Tobias Kowatsch
;
Linda D. Breeman
;
Veronica R. Janssen
;
Roderik A. Kraaijenhagen
;
Hareld M.C. Kemps
;
Andrea W.M. Evers

Background Financial incentives are a promising tool to help people increase their physical activity, but they are expensive to provide. Deposit contracts are a type of financial incentive in which participants pledge their own money. However, low uptake is a crucial obstacle to the large-scale implementation of deposit contracts. Therefore, we investigated whether (1) matching the deposit 1:1 (doubling what is deposited) and (2) allowing for customizable deposit amounts increased the uptake and short term effectiveness of a deposit contract for physical activity. Methods In this randomized controlled trial, 137 healthy students (age M = 21.6 years) downloaded a smartphone app that provided them with a tailored step goal and then randomized them to one of four experimental conditions. The deposit contract required either a €10 fixed deposit or a customizable deposit with any amount between €1 and €20 upfront. Furthermore, the deposit was either not matched or 1:1 matched (doubled) with a reward provided by the experiment. During 20 intervention days, daily feedback on goal progress and incentive earnings was provided by the app. We investigated effects on the uptake (measured as agreeing to participate and paying the deposit) and effectiveness of behavioral adoption (measured as participant days goal achieved). Findings Overall, the uptake of deposit contracts was 83.2%, and participants (n = 113) achieved 14.9 out of 20 daily step goals. A binary logistic regression showed that uptake odds were 4.08 times higher when a deposit was matched (p = .010) compared to when it was not matched. Furthermore, uptake odds were 3.53 times higher when a deposit was customizable (p = .022) compared to when it was fixed. Two-way ANCOVA showed that matching (p = .752) and customization (p = .143) did not impact intervention effectiveness. However, we did find a marginally significant interaction effect of deposit matching X deposit customization (p = .063, ηp2 = 0.032). Customization decreased effectiveness when deposits were not matched (p = .033, ηp2 = 0.089), but had no effect when deposits were matched (p = .776, ηp2 = 0.001). Conclusions We provide the first experimental evidence that both matching and customization increase the uptake of a deposit contract for physical activity. We recommend considering both matching and customization to overcome lack of uptake, with a preference for customization since matching a deposit imposes significant additional costs. However, since we found indications that customizable deposits might reduce effectiveness (when the deposits are not matched), we urge for more research on the effectiveness of customizable deposit contracts. Finally, future research should investigate which participant characteristics are predictive of deposit contract uptake and effectiveness.

Type: journal article

Journal: Psychology of Sport and Exercise

Volume: 70

DOI: 10.1016/j.psychsport.2023.102532

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/118201
Perceived responsiveness in suicidal ideation: an experience sampling study in psychiatric patients

( 2024)
Laura Sels
;
Stephanie Homan
;
Harry Reis
;
Andrea B Horn
;
Jordan Revol
;
Urte Scholz
;
Tobias Kowatsch
;
Birgit Kleim

Introduction Perceived responsiveness, or the extent to which one feels understood, validated and cared for by close others, plays a crucial role in people's well-being. Can this interpersonal process also protect people at risk? We assessed whether fluctuations in suicidal ideation were associated with fluctuations in the degree of perceived responsiveness that psychiatric patients (admitted in the context of suicide or indicating suicidal ideation) experienced in daily interactions immediately after discharge. Methods Fifty-seven patients reported on suicidal ideation (5 times a day) and perceived responsiveness (daily) for four consecutive weeks. The effects of established risk factors—thwarted belongingness, perceived burdensomeness, and hopelessness—were assessed as well. Results The more patients felt that close others had been responsive to them, the less suicidal ideation they reported. At low levels of thwarted belongingness, perceived burdensomeness, or hopelessness, perceived responsiveness seemed to play a protective role, negatively co-occurring with suicidal ideation. When thwarted belongingness, perceived burdensomeness, and hopelessness were high, perceived responsiveness did not have an effect. Conclusion Perceived responsiveness could be a protective factor for suicidal ideation for people at risk only when they are experiencing low levels of negative perceptions. When experiencing highly negative perceptions, however, perceived responsiveness seems to matter less.

Type: journal article

Journal: Suicide and Life-Threatening Behavior

DOI: 10.1111/sltb.13095

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/120239
Smartwatches for non‐invasive hypoglycaemia detection during cognitive and psychomotor stress

( 2024)
Martin Maritsch
;
Simon Föll
;
Vera Lehmann
;
Naïma Styger
;
Caterina Bérubé
;
Mathias Kraus
;
Stefan Feuerriegel
;
Tobias Kowatsch
;
Thomas Züger
;
Elgar Fleisch
;
Felix Wortmann
;
Christoph Stettler

Type: journal article

Journal: Diabetes, Obesity and Metabolism

Volume: 26 (3)

DOI: 10.1111/dom.15402

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/118950

Scopus© Citations 1
Optimizing Outcomes in Psychotherapy for Anxiety Disorders Using Smartphone-Based and Passive Sensing Features: Protocol for a Randomized Controlled Trial

( 2024)
Miriam Müller-Bardorff
;
Ava Schulz
;
Christina Paersch
;
Dominique Recher
;
Barbara Schlup
;
Erich Seifritz
;
Iris Tatjana Kolassa
;
Tobias Kowatsch
;
Aaron Fisher
;
Isaac Galatzer-Levy
;
Birgit Kleim

Background Psychotherapies, such as cognitive behavioral therapy (CBT), currently have the strongest evidence of durable symptom changes for most psychological disorders, such as anxiety disorders. Nevertheless, only about half of individuals treated with CBT benefit from it. Predictive algorithms, including digital assessments and passive sensing features, could better identify patients who would benefit from CBT, and thus, improve treatment choices. Objective This study aims to establish predictive features that forecast responses to transdiagnostic CBT in anxiety disorders and to investigate key mechanisms underlying treatment responses. Methods This study is a 2-armed randomized controlled clinical trial. We include patients with anxiety disorders who are randomized to either a transdiagnostic CBT group or a waitlist (referred to as WAIT). We index key features to predict responses prior to starting treatment using subjective self-report questionnaires, experimental tasks, biological samples, ecological momentary assessments, activity tracking, and smartphone-based passive sensing to derive a multimodal feature set for predictive modeling. Additional assessments take place weekly at mid- and posttreatment and at 6- and 12-month follow-ups to index anxiety and depression symptom severity. We aim to include 150 patients, randomized to CBT versus WAIT at a 3:1 ratio. The data set will be subject to full feature and important features selected by minimal redundancy and maximal relevance feature selection and then fed into machine leaning models, including eXtreme gradient boosting, pattern recognition network, and k-nearest neighbors to forecast treatment response. The performance of the developed models will be evaluated. In addition to predictive modeling, we will test specific mechanistic hypotheses (eg, association between self-efficacy, daily symptoms obtained using ecological momentary assessments, and treatment response) to elucidate mechanisms underlying treatment response. Results The trial is now completed. It was approved by the Cantonal Ethics Committee, Zurich. The results will be disseminated through publications in scientific peer-reviewed journals and conference presentations. Conclusions The aim of this trial is to improve current CBT treatment by precise forecasting of treatment response and by understanding and potentially augmenting underpinning mechanisms and personalizing treatment.

Type: journal article

Journal: JMIR Research Protocols

Volume: 13

DOI: 10.2196/42547

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/120221
The potential of wearable sweat sensors in heart failure management

( 2024)
Noé Brasier
;
Ole Frobert
;
Fiorangelo De Ieso
;
David Meyer
;
Tobias Kowatsch
;
Roozbeh Ghaffari

Wearable sweat sensors could be used to monitor patients with heart failure, providing a route to personalized and automated patient management in hospitals and at home.

Type: journal article

Journal: Nature Electronics

URL: https://www.nature.com/articles/s41928-024-01136-w

DOI: 10.1038/s41928-024-01136-w

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/119747

Scopus© Citations 2
Top-funded digital health companies offering lifestyle interventions for dementia prevention: Company overview and evidence analysis

( 2024)
Rasita Vinay
;
Jonas Probst
;
Panitda Huynh
;
Mathias Schlögl
;
Tobias Kowatsch
;
Marcia Nissen

Background and objective Dementia prevention has been recognized as a top priority by public health authorities due to the lack of disease modifying treatments. In this regard, digital dementia-preventive lifestyle services (DDLS) emerge as potentially pivotal services, aiming to address modifiable risk factors on a large scale. This study aims to identify the top-funded companies offering DDLS globally and evaluate their clinical evidence to gain insights into the current state of the global service landscape. Methods A systematic screening of two financial databases (Pitchbook and Crunchbase) was conducted. Corresponding published clinical evidence was collected through a systematic literature review and analyzed regarding study purpose, results, quality of results, and level of clinical evidence. Findings The ten top-funded companies offering DDLS received a total funding of EUR 128.52 million, of which three companies collected more than 75%. Clinical evidence was limited due to only nine eligible publications, small clinical subject groups, the absence of longitudinal study designs, and no direct evidence of dementia prevention. Conclusion The study highlights the need for a more rigorous evaluation of DDLS effectiveness in today’s market. It serves as a starting point for further research in digital dementia prevention.

Type: journal article

Journal: medRxiv

Volume: 2024.03.29.24305069

DOI: 10.1101/2024.03.29.24305069

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/119852
Factors associated with adherence to a public mobile nutritional health intervention: retrospective cohort study

( 2024)
Robert Jakob
;
Justas Narauskas
;
Elgar Fleisch
;
Laura Maria König
;
Tobias Kowatsch

Type: journal article

Journal: Computers in Human Behavior Reports

DOI: 10.1016/j.chbr.2024.100445

URI: https://www.alexandria.unisg.ch/handle/20.500.14171/120459

Tobias Kowatsch

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