Methods, systems, and apparatus, including computer programs encoded on a computer storage medium, for adapting communications and interactions to enhance monitoring using remote devices. In some implementations, a system communicates with remote devices that are each configured to perform monitoring. The system generates records that specify outcomes or responses obtained after sending the messages. The generated records are used to create or update profiles for different categories of users. Each profile has a set of inclusion criteria defining the category corresponding to the profile, and stores data that characterizes effects of message attributes on outcomes or responses for users in the category corresponding to the profile. The system selects a profile for each member of a group of users involved in a particular monitoring program, then adapts communication for each user based on the profile selected for the user.