This thesis adopts a Design Science Research (DSR) approach to address this gap by designing, instantiating, and justificatorily evaluating a digital coaching artefact tailored to the Swiss healthcare context. Drawing on validated evidence from diabetology, behavioral habit science, psychosocial research on diabetes distress, digital health interventions, and Swiss healthcare system analyses, the thesis develops a coherent blueprint for a closed-loop digital DSMES system. The artefact integrates habitformation mechanisms, distress-sensitive adaptation, and continuous feedback into a unified behavioral support model aligned with Swiss primary care workflows and SGED/SSED quality criteria.The proposed design deliberately centres on a small set of keystone behaviours—weekly weight monitoring and daily physical activity—as behaviourally manageable leading indicators of self-management stability. These behaviours anchor habit formation, enable early detection of behavioral drift, and support low-burden digital interaction. Rather than proposing a fully implemented clinical system, the thesis develops a conceptually grounded architecture and an exploratory prototype instantiation that translate interdisciplinary evidence into an operationally plausible digital coaching artefact.

Evaluation is conducted at an early Design Science Research maturity level, focusing on theoretical validity, mechanism coherence, contextual plausibility, and operational plausibility through exploratory prototype instantiation rather than empirical clinical outcomes. Expert interviews with a clinician, health economist, and an insurer representative are used to refine relevance and feasibility assumptions within the relevance cycle, without constituting outcome evidence.

The thesis contributes to research by demonstrating how established theories and empirical findings can be systematically integrated into a modification-type Design Science artefact for digital chronic care. Practically, it provides a theoretically grounded blueprint that can inform prototyping, pilot studies, and staged empirical evaluation of digital DSMES solutions within the Swiss healthcare system.