The Open Source Behavioral Intervention Platform designed by ETH Zurich, the University of St. Gallen and the Swiss Research Institute for Public Health and Addiction.
The vision of the MobileCoach team is to provide an open source behavioral intervention platform for fully-automated digital interventions. Due to a modular and extendable structure as well as an architecture rooted in the logics and legal claims of open-source software, the MobileCoach lays a fruitful ground for digital interventions in several application domains of behavior change. For example, the MobileCoach can be used to design and evaluate digital health interventions in the context of smoking cessation, nutrition or physical activity.
Based on personal characteristics and prior behavior assessed when participating in a digital intervention, the MobileCoach uses communication services (e.g. SMS) or sensor services (e.g. physical activity tracker) to monitor central indicators of the particular behavior on a regular basis. Building on individual data, MobileCoach users profit from individualized messages and valuable insights motivating for long-term behavior change.
An overview of a typical MobileCoach intervention is shown in Figure “A typical MobileCoach intervention” below. Following the registration process and an initial behavioral assessment at T0, the target behavior is monitored and according to it, participants receive a tailored intervention with individual feedback and recommendations until T1, for example, three to 12 months after T0. The long-term target behavior is finally evaluated in a follow-up assessment at T2, for example, three months after T1. This long-term target behavior is used as primary outcome variable to test the efficacy of the underlying MobileCoach intervention.
An overview of the various web based and SMS based user interfaces for participants of MobileCoach interventions is shown in Figure “The MobileCoach for participants” below. With the exception of the SMS based user interface, content and layout elements are fully customizable such that the target behavior can be supported as effective and efficient as possible. Native MobileCoach applications for mobile devices, desktop computers or ubiquitous computing environments will be made available as part of upcoming MobileCoach interventions and projects.
Domain experts such as physicians, psychologists or, more generally, behavioral intervention experts can use a lightweight web application to design and evaluate MobileCoach interventions. That is, no technical programming skills are required to design the baseline assessment, the tailored web-based feedback, the intervention rules or content elements. Some screenshots of the web application are shown in Figure “The MobileCoach for Domain Experts” below. Domain experts are also able to import and export interventions. This also includes an export of intervention data in the CSV format that allows further data processing and analyses with statistical packages such as R, Matlab or SPSS. However, real-time monitoring and longitudinal data analyses will be integrated directly in the MobileCoach web application in upcoming projects.
In the pilot phase, the MobileCoach will support two concrete health behaviors related to the public health context. For more information on these interventions, please go to the section Projects and read about our first projects MobileCoach Tobacco and MobileCoach Alcohol. Due to its open-source character, however, future research teams around the globe may contribute by adding features to the software and broadening the number of supported behaviors.
The first release of the open source MobileCoach platform can be downloaded in our section For Developers.
Last updated: August 7th, 2017
This is just a selection of MobileCoach projects. Please contact Tobias Kowatsch firstname.lastname@example.org if your project should be listed here, too.
The goals of this project are to systematically investigate the unique contributions of visible and invisible social support and common dyadic coping on health behaviors involved in diabetes management (e.g., physical activity, eating, medication adherence) and well-being of diabetes Type II patients and their partners; and to develop an ambulatory assessment application for smartphones for the open source behavioral intervention platform MobileCoach that allows (a) to record speech and recognize the affect of speech based on prosodic, spectral and sentiment analyses, (b) to objectively sense the degree of physical activity by smartphone sensors and (c) to collect self-report data in situ in order to better understand the predictors (visible and invisible social support and common dyadic coping). The project website is available here: Center for Digital Health Interventions - SNF Mobile Couple Support
The main aim of the planned research program is to test the efficacy of a smartphone-based intervention for intentional personality change using the open source platform MobileCoach that supports the design of evidence-based, scalable and low-cost interventions. The research strategy is threefold: (1) to develop a smartphone-based intervention to change personality traits, (2) to examine its efficacy to change personality traits in the desired direction, and (3) to examine underlying processes and mechanisms in an effort to improve the intervention outcomes. The project website is available here: Center for Digital Health Interventions - SNF Changing Personality Traits
The goal of the research project PathMate2 is to help support obese children, their parents and their physicians with modern technology in creating a healthier lifestyle. Computer scientists, engineers and medical experts are collaborating in this interdisciplinary project in order to develop an information system which will allow obese children and their physicians to stay in touch. Some of the good intentions and plans made during on-site consultations are forgotten soon thereafter. It is therefore especially important that obese children make the right decisions in their lifestyle and diet in their everyday life. With the help of PathMate2, physicians will be able to analyze the data of their patients in real time, provide them with tips or challenges tailored to their needs, and thus motivate them to make healthier choices. The project website is available here: Center for Digital Health Interventions - SNF PathMate 2
The main objective is to design just-in-time adaptive health interventions for individuals with asthma. Research has conclusively shown that effective disease management interventions can directly affect an asthmatic’s quality of life, enabling a life with almost no symptoms and constraints. To ensure efficacy in our digital asthma interventions, we combine cutting-edge technology with evidence-based medicine and behavioral science. Our vision is to enable people suffering from asthma to gain control over their disease, so that they can live their life to the fullest. The project website is available here: Center for Digital Health Interventions - CSS Mobile Asthma Companion
The main objective is to design just-in-time adaptive health interventions for individuals with diabetes. Research has conclusively shown that effective disease management interventions can directly affect the quality of life of individuals with diabetes. To ensure efficacy in our digital asthma interventions, we combine cutting-edge technology with evidence-based medicine and behavioral science. Our vision is to enable people suffering from diabetes to gain control over their disease, so that they can live their life to the fullest. The project website is available here: Center for Digital Health Interventions - CSS Mobile Diabetes Companion
Mobile Diet Coach aims to provide fully-automated interventions to improve food literacy and support health-promoting dietary behaviors. The project website is available here: Center for Digital Health Interventions - Mobile Diet Coach
The aim of the myStep project is to realize the potential of digital health interventions in order to increase physical activity. The vision of myStep is to promote a more active lifestyle and thus contribute to prevent chronic diseases, enhance health and well-being and lower financial burdens of the health care system in a ubiquitous and effective way. The project website is available here: Center for Digital Health Interventions - CSS Physical Activity Interventions
Background: Substance use and misuse often first emerge during adolescence. Generic life skills training that is typically conducted within the school curriculum is effective at preventing the onset and escalation of substance use among adolescents. However, the dissemination of such programs is impeded by their large resource requirements in terms of personnel, money, and time. Life skills training provided via mobile phones might be a more economic and scalable approach, which additionally matches the lifestyle and communication habits of adolescents.
Objective: The aim of this study was to test the acceptance and initial effectiveness of an individually tailored mobile phone–based life skills training program in vocational school students.
Methods: The fully automated program, named ready4life, is based on social cognitive theory and addresses self-management skills, social skills, and substance use resistance skills. Program participants received up to 3 weekly text messages (short message service, SMS) over 6 months. Active program engagement was stimulated by interactive features such as quiz questions, message and picture-contests, and integration of a friendly competition with prizes in which program users collected credits with each interaction. Generalized estimating equation (GEE) analyses were used to investigate for changes between baseline and 6-month follow-up in the following outcomes: perceived stress, self-management skills, social skills, at-risk alcohol use, tobacco smoking, and cannabis use.
Results: The program was tested in 118 school classes at 13 vocational schools in Switzerland. A total of 1067 students who owned a mobile phone and were not regular cigarette smokers were invited to participate in the life skills program. Of these, 877 (82.19%, 877/1067; mean age=17.4 years, standard deviation [SD]=2.7; 58.3% females) participated in the program and the associated study. A total of 43 students (4.9%, 43/877) withdrew their program participation during the intervention period. The mean number of interactive program activities that participants engaged in was 15.5 (SD 13.3) out of a total of 39 possible activities. Follow-up assessments were completed by 436 of the 877 (49.7%) participants. GEE analyses revealed decreased perceived stress (odds ratio, OR=0.93; 95% CI 0.87-0.99; P=.03) and increases in several life skills addressed between baseline and the follow-up assessment. The proportion of adolescents with at-risk alcohol use declined from 20.2% at baseline to 15.5% at follow-up (OR 0.70, 95% CI 0.53-0.93; P=.01), whereas no significant changes were obtained for tobacco (OR 0.94, 95% CI 0.65-1.36; P=.76) or cannabis use (OR 0.91, 95% CI 0.67-1.24; P=.54).
Conclusions: These results reveal high-level acceptance and promising effectiveness of this interventional approach, which could be easily and economically implemented. A reasonable next step would be to test the efficacy of this program within a controlled trial.
Funding: Swiss Lung Association
Contact: Severin Haug email@example.com
Objective: To test the efficacy of a technology-based integratedsmoking cessation and alcohol intervention versus a smoking cessation only intervention in adolescents. Methods: This was a two-arm, parallel-group, cluster-randomised controlled trial with assessments at baseline and six months follow-up. Subjects in both groups received tailored mobile phone text messages to support smoking cessation for 3 months, and the option of registering for a programincorporating strategies for smoking cessation centred around a self-defined quit date. Subjects in the integrated intervention group also received tailored feedback regarding their consumption of alcohol and, for binge drinkers, tailored mobile phone text messages encouraging them to maintain their drinking within low-risk limits over a 3-month period. Primary outcomemeasureswere the 7-day point prevalence of smoking abstinence and change in cigarette consumption.
Results: In 360 Swiss vocational and upper secondary school classes, 2127 studentswho smoked tobacco regularly and owned a mobile phonewere invited to participate in the study. Of these, 1471 (69.2%) participated and 6-month follow-up data were obtained for 1116 (75.9%). No significant group differenceswere observed for any of the primary or secondary outcomes. Moderator analyses revealed beneficial intervention effects concerning 7-day smoking abstinence in participants with higher versus lower alcohol consumption.
Conclusions: Overall, the integrated smoking cessation and alcohol intervention exhibited no advantages over a smoking cessation only intervention, but it might be more effective for the subgroup of adolescent smokers with higher alcohol consumption. Providing a combined smoking cessation and alcohol intervention might be recommended for adolescent smokers with higher-level alcohol consumption.
Funding: Swiss Tobacco Prevention Fund
Contact: Severin Haug firstname.lastname@example.org
Objective: To test the efficacy of a combined web- and text messaging-based intervention to reduce problem drinking in young people compared to assessment only.
Method: Two-arm, parallel-group, cluster-randomized controlled trial with assessments at baseline and 6-month follow up. The automated intervention included online feedback, based on the social norms approach, and individually tailored text messages addressing social norms, outcome expectations, motivation, self-efficacy, and planning processes, provided over 3 months. The main outcome criterion was the prevalence of risky single-occasion drinking (RSOD, defined as drinking at least 5 standard drinks on a single occasion in men and 4 in women) in the past 30 days. Irrespective of alcohol consumption, 1,355 students from 80 Swiss vocational and upper secondary school classes, all of whom owned a mobile phone, were invited to participate in the study. Of these, 1,041 (76.8%) students participated in the study.
Results: Based on intention-to-treat analyses, RSOD prevalence decreased by 5.9% in the intervention group and increased by 2.6% in the control group, relative to that of baseline assessment (odds ratio [OR] _ 0.62, 95% confidence interval [CI] _ 0.44 –0.87). No significant group differences were observed for the following secondary outcomes: RSOD frequency, quantity of alcohol consumed, estimated peak blood alcohol concentration, and overestimation of peer drinking norms.
Conclusions: The intervention program reduced RSOD, which is a major indicator of problem drinking in young people, effectively.
Funding: Swiss National Science Foundation
Contact: Severin Haug email@example.com
Behavioral research teams all around the globe are invited to collaborate with the MobileCoach team or to simply download, setup and use their own instance of the MobileCoach platform. Moreover, healthcare providers or other companies interested in fully-automated behavioral interventions are also invited to contact the MobileCoach team for joint projects.
As of today, the following research institutes discuss, design, provide and/or evaluate MobileCoach interventions:
Prof. Dr. Elgar Fleisch
Prof. Dr. Elgar Fleisch
Prof. Dr. med. Georg F. Bauer, DrPH
Prof. Dr. Urte Scholz
Prof. Dr. Mathias Allemand
PD Dr. Severin Haug
Prof. David F. Kotz, PhD
Joy Gabrielli, PhD
The following companies or public institutions discuss, design, provide and/or evaluate MobileCoach interventions:
Dr. Rebecca Brauchli
Chairwoman of the management board
The initiators of the MobileCoach were eager to make this platform freely available to academia, public institutions and industry with the overall goal to promote further development resulting in useful evidence-based behavioral interventions. In this regard, the MobileCoach team has chosen the Apache 2 open source license such that the MobileCoach can even be used in commercial applications without any legal hassles.
Building on the foundations of automata theory, the technical design of the MobileCoach system follows the concepts of a state machine that uses intervention rules for state transitions, which can be referred to as a fully automated expert system. Here, the state is an aggregate of all relevant attributes related to the intervention progress of a participant (e.g. the messages received or answers provided) whereas state transitions triggered by intervention rules lead to a change in these attributes and thus, to a state change.
In particular, each participant of the intervention group is assigned to a particular intervention state based on her answers during the baseline assessment. In response to this assessment, a web-based feedback is generated individually by the system for each participant. Then, depending on a participant’s regular feedback (e.g. via text messages or sensor data from internet of things services) during the subsequent months, intervention rules trigger state transitions and the tailoring of the follow-up communication. In particular, intervention rules are traversed on a regular basis (e.g. once a day) for each participant, and, as a result, update the state of the corresponding participant and start communication (e.g. via text messages) in the form of a question, a feedback or a recommendation.
With upcoming projects, tailoring of interventions and prediction of state transitions with the help of machine learning algorithms will be the primary research focus of the MobileCoach team. As a summary, the three building blocks of MobileCoach interventions are depicted in Figure “Building Blocks of MobileCoaching”.
The technical architecture of this rule-based state machine as shown in Figure “The MobileCoach Architecture” is derived from the model-view-controller design pattern. It consists therefore of…
a persistence layer, i.e. the model based on the document database mongoDB and plain files for storing the intervention content including a detailed protocol of all incoming and outgoing communication.
Password protection and Secure Sockets Layer (SSL) encoding are used to ensure the privacy and safety of data transfer.
Download our MobileCoach source code from our GIT repository or as ZIP/GZ/BZ2 archive:
MobileCoach repository containing all repositories and instructions
MobileCoach CORE component: (required)
MobileCoach FileServletWrapper component:
MobileCoach Website component:
Detailed information on how to setup MobileCoach on your own server can be found here:
Paz, R., Haug, S., Filler, A., Kowatsch, T., Schaub, M.P. (2017) Engagement within a Mobile Phone-based Smoking Cessation Intervention for Adolescents and Its Association with Participant Characteristics and Outcomes, Journal of Medical Internet Research (JMIR) 19(10):e356. PDF
Künzler, F., Kramer, J., Kowatsch, T. (2017) Efficacy of Mobile Context-aware Notification Management Systems: A Systematic Literature Review and Meta-Analysis, Fifth International Workshop on Pervasive and Context-Aware Middleware (PerCAM’17), co-located with the 13th IEEE International Conference on Wireless and Mobile Computing, Networking and Communications (WiMob 2017), Rome, Italy. PDF
Haug, S., Paz, R., Meyer, C., Filler, A., Kowatsch, T., Schaub, M.P. (2017) A Mobile Phone-Based Life Skills Training Program for Substance Use Prevention Among Adolescents: Pre-Post Study on the Acceptance and Potential Effectiveness of the Program Ready4life, JMIR Mhealth Uhealth 5(10):e143. PDF
Kowatsch, T., Nißen, M.K., Shih, I., Rüegger, D., Volland, D., Filler, A., Künzler, F., Barata, F., Haug, S., Büchter, D., Brogle, B., Heldt, K., Gindrat, P., Farpour-Lambert, N., l’Allemand, D. (2017) Text-based Healthcare Chatbots Supporting Patient and Health Professional Teams: Preliminary Results of a Randomized Controlled Trial on Childhood Obesity, Persuasive Embodied Agents for Behavior Change (PEACH 2017) Workshop, co-located with the 17th International Conference on Intelligent Virtual Agents (IVA 2017), Stockholm, Sweden. PDF
Haug, S., Paz, R., Kowatsch, T., Filler, A., Schaub, M.P. (2017) Efficacy of a Technology-based Integrated Smoking Cessation and Alcohol Intervention for Smoking Cessation in Adolescents: Results of a Cluster-randomised Controlled Trial, Journal of Substance Abuse Treatment 82(11), 55-66. PDF
Kowatsch, T., Wahle, F., Filler, A. (2017) Design and Lab Experiment of a Stress Detection Service based on Mouse Movements, The 11th Mediterranean Conference on Information Systems (MCIS), Genoa, Italy Best Paper Award PDF
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. (2017) Design and Evaluation of a Mobile Chat App for the Open Source Behavioral Health Intervention Platform MobileCoach, In: Maedche A., vom Brocke J., Hevner A. (eds) Designing the Digital Transformation. DESRIST 2017. Lecture Notes in Computer Science, vol 10243. Springer: Berlin; Germany, 485-489. Paper Poster Screencast
Haug, S., Paz, R., Kowatsch, T., Filler, A., Dickson-Spillmann, M., Dey, M., Schaub, M.P. (2017) Efficacy of a web- and text messaging-based intervention to reduce problem drinking in adolescents: Results of a cluster-randomised controlled trial, Journal of Consulting and Clinical Psychology, 85(2),147-159. PDF
Paz, R., Haug, S., Kowatsch, T., Filler, A., Schaub, M.P. (2017) Moderators of Outcome in a Technology-based Intervention to Prevent and Reduce Problem Drinking Among Adolescents, Addictive Behaviors 72: 64-71. PDF
Kowatsch, T., Wahle, F., Filler, A. (2017) stressOUT: Design, Implementation and Evaluation of a Mouse-based Stress Management Service, In: Designing the Digital Transformation: DESRIST 2017 Research in Progress Proceedings, Maedche, A., vom Brocke, J., Hevner, A. (eds), KIT Scientific Working Papers; 64, Karlsruhe, Germany, 37-45. Nominee for the Best Research-in-Progress PDF
Tinschert, P., Barata, F., Kowatsch, T. (2017) Enhancing Asthma Control through IT: Design, Implementation and Planned Evaluation of the Mobile Asthma Companion, in Leimeister, J.M.; Brenner, W. (Hrsg.): Proceedings der 13th International Conference on Wirtschaftsinformatik (WI 2017), St. Gallen, 1291-1294. PDF Video
Barata, F., Kowatsch, T., Tinschert, P., Filler, A. (2016). Personal MobileCoach: Tailoring Behavioral Interventions to the Needs of Individual Participants. UBICOMP 2016 Workshop Designing, Developing, and Evaluating The Internet of Personal Health (IoPH), Heidelberg, Germany. PDF
Haug, S., Paz, R., Kwon, M., Filler, A., Kowatsch, T., Schaub, M.P. (2015). Smartphone use and Smartphone addiction among young people in Switzerland. Journal of Behavioural Addictions 4(4), pp. 299-307. PDF
Filler, A., Kowatsch, T., Haug, S., Wahle, F., Staake, T. & Fleisch, E. (2015). MobileCoach: A Novel Open Source Platform for the Design of Evidence-based, Scalable and Low-Cost Behavioral Health Interventions - Overview and Preliminary Evaluation in the Public Health Context. Wireless Telecommunications Symposium 2015 (WTS 2015), New York, USA. PDF Technical Focus Outstanding Paper Award & Best Graduate Student Paper Award
Haug, S., Paz Castro, R., Filler, A., Kowatsch, T., Fleisch, E. & Schaub, M.P. (2014). Efficacy of an internet and SMS-based integrated smoking cessation and alcohol intervention for smoking cessation in young people: study protocol of a two-arm cluster randomised controlled trial. BMC Public Health, 14: 1140. PDF Intervention Focus
Filler, A., Haug, S. and Kowatsch, T. (2014). The MobileCoach – An Open Source Solution for Behavioral Change Interventions. Abstract presented at the 7th Scientific Meeting of The International Society for Research on Internet Interventions (ISRII), Valencia, Spain. PDF Technical Focus
Kowatsch, T., Wahle, F., Filler, A. and Fleisch, E. (2014) Predicting Adverse Behavior with Early Warning Health Information Systems by Mining Association Rules on Multi-dimensional Behavior: A Proposal. Poster presented at the 7th Scientific Meeting of The International Society for Research on Internet Interventions (ISRII), Valencia, Spain. PDF Technical Focus
Haug, S., Kowatsch, T., Paz Castro, R., Filler, A. and Schaub, M.P. (2014) Efficacy of a web- and text messaging-based intervention to reduce problem drinking in young people: study protocol of a cluster-randomised controlled trial. BMC Public Health, 14: 809. PDF Intervention Focus
Haug, S. (2013). Mobile phone text messaging to reduce alcohol and tobacco use in young people – a narrative review. Smart Homecare Technology and TeleHealth, 1(1), 11-19. PDF Intervention Focus
Haug, S. Bitter, G., Hanke, M., Ulbricht, S. Meyer, C. & John, U. (2013). Kurzintervention zur Förderung der Tabakabstinenz via Short Message Service (SMS) bei Auszubildenden an beruflichen Schulen: Longitudinale Interventionsstudie zur Ergebnis- und Prozessevaluation. Das Gesundheitswesen, 75(10), 625-631. Intervention Focus
Haug, S., Schaub, M.P., Venzin, V. Meyer, C. & John, U. (2013). Differenzielle Wirksamkeit eines Short Message Service (SMS)-basierten Programms zur Förderung des Rauchstopps bei Jugendlichen. Psychiatrische Praxis, 40(6), 339-346. Intervention Focus
Haug, S., Schaub, M.P., Venzin, V., Meyer, C., John, U. & Gmel, G. (2013). A pre-post study on the appropriateness and effectiveness of a web- and text messaging-based intervention to reduce problem drinking in emerging adults. Journal of Medical Internet Research, 15(9), e196. PDF Intervention Focus
Haug, S., Schaub, M.P., Venzin, V., Meyer, C. & John, U. (2013). Efficacy of a text message-based smoking cessation intervention for young people: a cluster randomized controlled trial. Journal of Medical Internet Research, 15(8), e171. PDF Intervention Focus
Haug, S., Venzin, V. & Meyer, C. (2012). Förderung des Rauchstopps an Berufsfachschulen via SMS. SuchtMagazin, 38(3/4), 38-42. Intervention Focus
The MobileCoach is continuously improved by an interdisciplinary research team. Among the various disciplines, team members are particularly experts in computer science, psychology and the field of public health. Please notice that there are many individuals working on the MobileCoach system or MobileCoach interventions. Here is just the list of individuals that started to work together on MobileCoach back in 2014.
Doctor of Philosophy in Management (Ph.D.), MSc in Business Informatics, MSc in Computer Science in Media & Dipl.-Inform. (FH) in Computer Science in Media
Chair of Information Management at the Department of Management, Technology and Economics, ETH Zurich, and Chair of Operations Management at the Institute of Technology Management, University of St. Gallen
M.Sc. in Computer Science in Media & Dipl.-Inform. (FH) in Computer Science in Media
Doctor of Philosophy in Management (Ph.D.), Dipl.-Winf (M.Sc.) in Business Informatics
Please let us know if you have any further questions or comments regarding the MobileCoach platform. We are eager to learn from your experience to improve the MobileCoach.
For general research activities or collaboration requests related to the MobileCoach, please contact Tobias Kowatsch firstname.lastname@example.org.
For details on addiction-related interventions or collaborations, please contact our domain expert Severin Haug email@example.com.
For requests related to professional product development of clinical pathways, please contact Michelle Heppler of Pathmate Technologies firstname.lastname@example.org.
Publisher: Center for Digital Health Interventions, Chair of Operations Management at the Institute of Technology Management, University of St. Gallen.
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