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Can we use LLMs to bootstrap reinforcement learning? -- A case study in digital health behavior change

19 November 2025
Nele Albers
Esra Cemre Su de Groot
Loes Keijsers
Manon H. Hillegers
Emiel Krahmer
    OffRLLM&MA
ArXiv (abs)PDFHTML
Main:20 Pages
30 Figures
Bibliography:9 Pages
4 Tables
Appendix:20 Pages
Abstract

Personalizing digital applications for health behavior change is a promising route to making them more engaging and effective. This especially holds for approaches that adapt to users and their specific states (e.g., motivation, knowledge, wants) over time. However, developing such approaches requires making many design choices, whose effectiveness is difficult to predict from literature and costly to evaluate in practice. In this work, we explore whether large language models (LLMs) can be used out-of-the-box to generate samples of user interactions that provide useful information for training reinforcement learning models for digital behavior change settings. Using real user data from four large behavior change studies as comparison, we show that LLM-generated samples can be useful in the absence of real data. Comparisons to the samples provided by human raters further show that LLM-generated samples reach the performance of human raters. Additional analyses of different prompting strategies including shorter and longer prompt variants, chain-of-thought prompting, and few-shot prompting show that the relative effectiveness of different strategies depends on both the study and the LLM with also relatively large differences between prompt paraphrases alone. We provide recommendations for how LLM-generated samples can be useful in practice.

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