Remotely Delivered, Culturally Tailored Weight Loss Interventions Among Latina Breast Cancer Survivors

Not Applicable

Recruiting

• Conditions: Anatomic Stage I Breast Cancer AJCC v8; Anatomic Stage II Breast Cancer AJCC v8; Anatomic Stage III Breast Cancer AJCC v8
• Interventions: Behavioral: Behavioral Intervention; Procedure: Biospecimen Collection; Behavioral: Behavioral Dietary Intervention; Other: Health Promotion and Education; Other: Dietary Intervention; Other: Educational Intervention; Other: Exercise Intervention; Other: Internet-Based Intervention; Other: Interview; Behavioral: Lifestyle Counseling; Other: Medical Device Usage and Evaluation; Other: Nutritional Intervention; Other: Questionnaire Administration; Behavioral: Telephone-Based Intervention

• Registration Number: NCT05930483
• Lead Sponsor: Fred Hutchinson Cancer Center

Brief Summary

This clinical trial evaluates a remotely delivered, culturally tailored weight loss interventions in Latina breast cancer (BC) survivors. Cancer is the leading cause of death among Latinos, and among Latinas, BC is the leading cause of cancer death. An estimated 80% of Latinas in the United States have overweight/obesity, which is associated with poorer BC outcomes. However, few, if any, effective interventions exist to promote and maintain weight loss in Latina BC survivors. The development of an adaptive program that provides survivors the support they need, as opposed to what is typically available, is essential to reducing persistent inequities in cancer survivorship.

Detailed Description

OUTLINE: This study includes a baseline run-in and randomized stage I and stage II studies.

BASELINE: Participants receive written instructions and website link to an instructional video along with supportive materials including measuring tape, Aria wireless fidelity (WiFi)-enabled scale, and Actigraph accelerometer to be worn for 7 days at baseline. Patients also undergo blood sample collection at baseline.

STAGE I: Eligible participants from the baseline run-in are randomized to arm I or II.

ARM I: Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.

ARM II: Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.

STAGE II: Participants who achieve \>= 2% weight loss (responders) at week 4 will continue their assigned interventions in stage I. Participants who achieve \< 2% weight loss (non-responders) at week 4 will be re-randomized to 1 of 4 arms. Participants who were assigned to arm I in stage I are randomized to arm III or IV. Participants who were assigned to arm II in stage I are randomized to arms V or VI.

ARM III: Participants receive interventions as in arm II.

ARM IV: Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.

ARM V: Participants receive interventions as in arm IV.

ARM VI: Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.

Study Timeline

• Study First Submitted: 2023-06-26
• Study First Submitted QC: 2023-06-26
• Study First Posted: 2023-07-05
• Status Verified: 2025-03
• Study Start: 2025-04-08
• Last Update Submitted: 2025-04-24
• Last Update Posted: 2025-04-27
• Primary Completion: 2028-03-01
• Study Completion: 2028-03-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: Female
• Target Recruitment: 640

Inclusion Criteria

• Biologically female
• Age >= 18 years
• Self-identifies Hispanic/Latina
• Fluent in Spanish and/or English
• Previously diagnosis of stage I-III BC within the past 5 years
• No evidence of recurrent or metastatic disease
• > 60 days post treatment (current endocrine therapy allowed)
• Body mass index (BMI) >= 30 kg/m^2 initially assessed via self-reported height and weight and confirmed prior to randomization via a tape measure and WiFi-enabled scale
• Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
• Physician written clearance for participation in a 12 month weight loss program
• Willingness to participate in all study activities
• Access to phone for study contacts
• Access to internet and smartphone, tablet, or computer to participate in the online program and to be able to sync study WiFi devices
• Lives within grocery delivery range for online delivery service
• Successful completion of at-home baseline assessments prior to randomization

Exclusion Criteria

• Body mass index (BMI) < 30 kg/m^2
• Active smoker
• Diabetic with use of insulin or other hypoglycemic medication
• Major comorbidities or physical limitations that would preclude from healthy weight loss, reducing energy intake or engaging in PA
• Pregnant, breastfeeding, or planning to become pregnant during the study period
• Use of exogenous hormones for gender affirmation

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Internet-Based Intervention	Participants receive interventions as in arm IV.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Interview	Participants receive interventions as in arm II.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Questionnaire Administration	Participants receive interventions as in arm II.
Stage I, Arm I (¡Vida!)	Behavioral Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage I, Arm I (¡Vida!)	Educational Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Lifestyle Counseling	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Medical Device Usage and Evaluation	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Baseline (instructions, video, tape, scale, accelerometer)	Medical Device Usage and Evaluation	Participants receive written instructions and website link to an instructional video along with supportive materials including measuring tape, Aria WiFi-enabled scale, and Actigraph accelerometer to be worn for 7 days at baseline. Patients also undergo blood sample collection at baseline.
Baseline (instructions, video, tape, scale, accelerometer)	Biospecimen Collection	Participants receive written instructions and website link to an instructional video along with supportive materials including measuring tape, Aria WiFi-enabled scale, and Actigraph accelerometer to be worn for 7 days at baseline. Patients also undergo blood sample collection at baseline.
Baseline (instructions, video, tape, scale, accelerometer)	Health Promotion and Education	Participants receive written instructions and website link to an instructional video along with supportive materials including measuring tape, Aria WiFi-enabled scale, and Actigraph accelerometer to be worn for 7 days at baseline. Patients also undergo blood sample collection at baseline.
Baseline (instructions, video, tape, scale, accelerometer)	Questionnaire Administration	Participants receive written instructions and website link to an instructional video along with supportive materials including measuring tape, Aria WiFi-enabled scale, and Actigraph accelerometer to be worn for 7 days at baseline. Patients also undergo blood sample collection at baseline.
Stage I, Arm I (¡Vida!)	Biospecimen Collection	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage I, Arm I (¡Vida!)	Interview	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage I, Arm I (¡Vida!)	Exercise Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage I, Arm I (¡Vida!)	Nutritional Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Behavioral Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Internet-Based Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage I, Arm I (¡Vida!)	Internet-Based Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Nutritional Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage I, Arm I (¡Vida!)	Dietary Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Questionnaire Administration	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Biospecimen Collection	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Dietary Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Exercise Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Interview	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage I, Arm I (¡Vida!)	Medical Device Usage and Evaluation	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage I, Arm I (¡Vida!)	Questionnaire Administration	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Educational Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Behavioral Intervention	Participants receive interventions as in arm II.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Educational Intervention	Participants receive interventions as in arm II.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Behavioral Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Biospecimen Collection	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Educational Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Biospecimen Collection	Participants receive interventions as in arm II.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Internet-Based Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Dietary Intervention	Participants receive interventions as in arm II.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Exercise Intervention	Participants receive interventions as in arm II.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Internet-Based Intervention	Participants receive interventions as in arm II.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Medical Device Usage and Evaluation	Participants receive interventions as in arm II.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Medical Device Usage and Evaluation	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Telephone-Based Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Dietary Intervention	Participants receive interventions as in arm IV.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Dietary Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Exercise Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Lifestyle Counseling	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage I, Arm II (¡Vida!, lifestyle sessions)	Nutritional Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions on study. Patients also undergo blood sample collection on study.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Nutritional Intervention	Participants receive interventions as in arm II.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Questionnaire Administration	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Behavioral Intervention	Participants receive interventions as in arm IV.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Behavioral Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm III (¡Vida!, lifestyle sessions)	Lifestyle Counseling	Participants receive interventions as in arm II.
Stage II, Arm IV (¡Vida!, lifestyle sessions, coaching)	Interview	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions. Patients also undergo blood sample collection on study.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Exercise Intervention	Participants receive interventions as in arm IV.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Biospecimen Collection	Participants receive interventions as in arm IV.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Educational Intervention	Participants receive interventions as in arm IV.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Interview	Participants receive interventions as in arm IV.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Nutritional Intervention	Participants receive interventions as in arm IV.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Telephone-Based Intervention	Participants receive interventions as in arm IV.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Internet-Based Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Interview	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Lifestyle Counseling	Participants receive interventions as in arm IV.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Medical Device Usage and Evaluation	Participants receive interventions as in arm IV.
Stage II, Arm V (¡Vida!, lifestyle sessions, coaching)	Questionnaire Administration	Participants receive interventions as in arm IV.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Behavioral Dietary Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Biospecimen Collection	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Educational Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Telephone-Based Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Dietary Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Exercise Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Lifestyle Counseling	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Medical Device Usage and Evaluation	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Nutritional Intervention	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.
Stage II, Arm VI (¡Vida!, lifestyle sessions, coaching, food))	Questionnaire Administration	Participants participate in the online ¡Vida! program consisting of 26 health education online sessions, dietary modifications, and home-based exercise sessions on study. Participants receive supportive materials consisting of a Fitbit Aria scale, a Fitbit Luxe (or latest device), the Fitbit app, and access to the Cook for Your Life website on study. Participants also attend remote lifestyle health education sessions and receive 14 30-minute individualized telephone health coaching sessions and receive a bag of groceries each month on study. Patients also undergo blood sample collection on study.

Primary Outcome Measures

Name	Time	Method
Body weight (kg) percent change	Up to 12 months	Will be assessed by the percent of weight loss at month 12 and compared across the four embedded adaptive intervention (EAI) groups using the doubly robust estimator model.

Secondary Outcome Measures

Name	Time	Method
Body weight (kg) percent change as moderated by baseline characteristics	Up to 12 months	Will be determined by whether EAI effectiveness is moderated by baseline patient characteristics.

Trial Locations

Locations (1)

Fred Hutch/University of Washington Cancer Consortium; 🇺🇸 Seattle, Washington, United States