Laura Hawkins

Dominik P. Hofer, Haochen Song, Rania Islambouli et al.

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.

Haochen Song, Dominik Hofer, Rania Islambouli et al.

Machine learning approaches, such as contextual multi-armed bandit (cMAB) algorithms, offer a promising strategy to reduce sedentary behavior by delivering personalized interventions to encourage physical activity. However, cMAB algorithms typically require large participant samples to learn effectively and may overlook key psychological factors that are not explicitly encoded in the model. In this study, we propose a hybrid approach that combines cMAB for selecting intervention types with large language models (LLMs) to personalize message content. We evaluate four intervention types: behavioral self-monitoring, gain-framed, loss-framed, and social comparison, each delivered as a motivational message aimed at increasing motivation for physical activity and daily step count. Message content is further personalized using dynamic contextual factors including daily fluctuations in self-efficacy, social influence, and regulatory focus. Over a seven-day trial, participants receive daily messages assigned by one of four models: cMAB alone, LLM alone, combined cMAB with LLM personalization (cMABxLLM), or equal randomization (RCT). Outcomes include daily step count and message acceptance, assessed via ecological momentary assessments (EMAs). We apply a causal inference framework to evaluate the effects of each model. Our findings offer new insights into the complementary roles of LLM-based personalization and cMAB adaptation in promoting physical activity through personalized behavioral messaging.