A Diffusion-Model Subpopulation Digital Twin for Mobile Health Deployment: A Case Study on the HeartSteps Intervention

Mobile-health interventions increasingly use online learning and decision making algorithms to personalize when to nudge users toward healthier behavior, but a poorly designed algorithm can burden and disengage participants. New algorithm design decisions should therefore be vetted against realistic simulated users before each real-life deployment. We propose a method to develop ``JITAI-Twins'': digital twins of a target subpopulation for comparing candidate online algorithms before a just-in-time adaptive intervention (JITAI) deployment. The method builds on a conditional time-series diffusion model that is temporally consistent (future actions do not affect the generated past), and it supports repeated updating from three sources of information, in three steps: pre-training on a large observational dataset, fine-tuning on small prior intervention deployments in related populations, and inference-time calibration to the next target population from domain-scientist expertise. We validate the twin at each pre-deployment stage of the long-running HeartSteps series (v2 through v4) of physical-activity suggestion intervention deployments, treating each successive deployment as an upcoming study. The proposed method reproduces the target subpopulation's temporal and between-participant structure better than simpler simulators. These results suggest that our twin can be used to simulate a target deployment before it runs, the prerequisite for testing and informing online algorithm design decisions.

Making Small Language Models Efficient Reasoners: Intervention, Supervision, Reinforcement

Recent research enhances language model reasoning by scaling test-time compute via longer chain-of-thought traces. This often improves accuracy but also introduces redundancy and high computational cost, especially for small language models distilled with supervised fine-tuning (SFT). In this work, we propose new algorithms to improve token-efficient reasoning with small-scale models by effectively trading off accuracy and computation. We first show that the post-SFT model fails to determine the optimal stopping point of the reasoning process, resulting in verbose and repetitive outputs. Verbosity also significantly varies across wrong vs correct responses. To address these issues, we propose two solutions: (1) Temperature scaling (TS) to control the stopping point for the thinking phase and thereby trace length, and (2) TLDR: a length-regularized reinforcement learning method based on GRPO that facilitates multi-level trace length control (e.g. short, medium, long reasoning). Experiments on four reasoning benchmarks, MATH500, AMC, AIME24 and OlympiadBench, demonstrate that TS is highly effective compared to s1's budget forcing approach and TLDR significantly improves token efficiency by about 50% with minimal to no accuracy loss over the SFT baseline. Moreover, TLDR also facilitates flexible control over the response length, offering a practical and effective solution for token-efficient reasoning in small models. Ultimately, our work reveals the importance of stopping time control, highlights shortcomings of pure SFT, and provides effective algorithmic recipes.