Structured Exploration vs. Generative Flexibility: A Field Study Comparing Bandit and LLM Architectures for Personalised Health Behaviour Interventions

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Authors: Dominik P. Hofer, Haochen Song, Rania Islambouli, Laura Hawkins, Ananya Bhattacharjee, Meredith Franklin, Joseph Jay Williams, Jan David Smeddinck
Cited by: 1

Abstract

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.

Fields of Study & Subjects

Digital Mental Health Interventions Innovative Human-Technology Interaction Mobile Health and mHealth Applications

Publication details

Journal / source
arXiv (Cornell University)
Publication date
6 March 2026
Document type
Preprint