Structured Exploration vs. Generative Flexibility: A Field Study Comparing Bandit and LLM Architectures for Personalised Health Behaviour Interventions
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Abstract (arXiv)
Behaviour Change Techniques (BCTs) are central to digital health interventions, yet selecting and delivering effective techniques remains challenging. Contextual bandits enable statistically grounded optimisation of BCT selection, while Large Language Models (LLMs) offer flexible, context-sensitive message generation. We conducted a 4-week study on physical activity motivation (N=54; 9 post-study interviews) that compared five daily messaging approaches: random templates, contextual bandit with templates, LLM generation, hybrid bandit+LLM, and LLM with interaction history. LLM-based approaches were rated substantially more helpful than templates, but no significant differences emerged among LLM conditions. Unexpectedly, bandit optimisation for BCTs selection yielded no additional perceived helpfulness compared with LLM-only approaches. Unconstrained LLMs focused heavily on a single BCT, whereas bandit systems enforced systematic exploration-exploitation across techniques. Quantitative and qualitative findings suggest contextual acknowledgement of user input drove perceived helpfulness. We contribute design suggestions for reflective AI health behaviour change systems that address a trade-off between structured exploration and generative autonomy.
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References · 9
- 2019Personalized HeartSteps: A Reinforcement Learning Algorithm for Optimizing Physical Activitycited by 70
- 2023Towards LLM-guided Causal Explainability for Black-box Text Classifierscited by 44
- 2025LLMs syntactically adapt their language use to their conversational partnercited by 15
- 2022Artificial Intelligence for Health Message Generation: Theory, Method, and an Empirical Study Using Prompt Engineeringcited by 14
- 2023Scalable Neural Contextual Bandit for Recommender Systemscited by 12
- 2024The Last JITAI? Exploring Large Language Models for Issuing Just-in-Time Adaptive Interventions: Fostering Physical Activity in a Conceptual Cardiac Rehabilitation Settingcited by 7
- 2025Exploring Personalized Health Support through Data-Driven, Theory-Guided LLMs: A Case Study in Sleep Healthcited by 7
- 2023Using Adaptive Bandit Experiments to Increase and Investigate Engagement in Mental Healthcited by 6
- 2025Tailored Behavior-Change Messaging for Physical Activity: Integrating Contextual Bandits and Large Language Modelscited by 1
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