Kevin Dolgin, a Ph.D. student of the RITM laboratory at Université Paris-Saclay, supervised by Professor Lydiane Nabec, will defend his Ph.D. thesis entitled “Patient engagement in support programs: leveraging consumer behavior theory to encourage behavioral change and enhance well-being,” on October 16, 2026. The PhD defense will be held at 9:30 AM in the Gaudemet Room (Building D of the Jean Monnet Faculty).

Composition of the jury:

  • Karine GALLOPEL-MORVAN, Professor, EHESP – Reviewer
  • Pierre VOLLE, Professor, Université Paris Dauphine PSL – Reviewer
  • Isabelle ROYER, Professor, Université Jean Moulin Lyon 3 – Examiner
  • Amélie CLAUZEL, Professor, Université Paris-Saclay – Examiner
  • Gérard REACH, Emeritus Professor, Université Sorbonne Paris Nord – Examiner

PhD Thesis Abstract: This thesis examines patient engagement in healthcare as a whole, and specifically in patient support programs (PSPs). It applies consumer behavior and services management theory to better understand the behavioral mechanisms that drive both initial and sustained participation in healthcare. The work builds on the observation that despite major advances in therapeutic innovation, the real-world effectiveness of healthcare interventions remains significantly constrained by a lack of corresponding advances in generating engagement. While the healthcare literature has extensively studied medication adherence, the literature on engagement has been far less voluminous and has been noticeably scant with respect to engagement with PSPs, which are among the primary tools used to address medication adherence. To address this issue, the thesis builds on the perspective of patients as consumers of health services, therefore incorporating concepts and frameworks from consumer behavior literature and broader work on behavioral science. Since PSPs are also fundamentally services, they invoke services management literature as well, including consideration of consumer behavior in a service context, the concept of service-dominant logic, and service design principles with respect to PSPs. The empirical portion of the thesis consists of three complementary studies.

The first study examines healthcare engagement among young adults in an acute care context. Using a quantitative experimentation design based on Protection Motivation Theory, the study explores how perceived threat, coping assessment and self-efficacy influence behavioral intentions across a simulated patient journey. The second study uses qualitative interviews with patients across multiple countries and pathologies, applying thematic analysis to investigate the drivers of patient engagement with PSPs. The analysis identifies a set of recurring dimensions including but extending beyond functional program benefits, notably: trust; interpersonal connection; and attunement to patient needs. The third study tests these findings quantitatively through a survey of French patients with chronic disease who have participated in PSPs. Exploratory and confirmatory factor analysis, followed by structural equation modeling, lead to the development of a PSP-specific adaptation of Commitment-Trust Theory. Results demonstrate that engagement is influenced primarily by relational constructs such as trust, connection and attunement, while the perceived benefits of the program features exert their influence indirectly rather than serving as direct determinants of engagement.

Building on these findings, the thesis makes both theoretical and managerial contributions. The theoretical contributions center on a broader understanding of healthcare engagement as a consumer behavior phenomenon, and extend services management theory by arguing that unlike conventional services in which customer participation is the result of volitional processes, treatments for chronic disease and in many cases, the support programs that accompany them, represent “imposed consumption”—choices driven by necessity, not desire, and typically determined by actors other than the consumer while being associated with a disease they would rather not have, fundamentally altering the assumptions traditionally associated with consumer behavior. Managerially, the thesis argues that PSP sponsors, notably the pharmaceutical industry, must adopt a stance more in line with servicedominant logic and it proposes a new framework for the design of PSPs. Ultimately, the thesis argues that the effectiveness of patient support initiatives depends less on the features they provide than on how they fit the lived realities of the patients they are intended to support, offering a new behavioral framework for designing more patientcentric healthcare services.