Abstract Purpose: Latina women experience a 20% higher breast cancer (BC) mortality rate than non-Latina women, with over 80% classified as overweight or obese—risk factors for recurrence. Few culturally tailored interventions support sustainable weight loss in this population. The ¡Vida! trial is a Sequential Multiple Assignment Randomized Trial (SMART) evaluating the feasibility and effectiveness of adaptive, remotely delivered weight loss strategies among Latina BC survivors with obesity. Participants in Washington and California are recruited via SEER registries and community outreach. Methods: Women who self-identify as Latina, have a prior diagnosis of stage I–III breast cancer, have completed treatment (endocrine therapy allowed), and have a body mass index (BMI) ≥27 kg/m2 are eligible. In Stage 1, participants are randomized to: (1) ¡Vida!, a virtually delivered, culturally adapted lifestyle weight loss program with 24 one-hour group sessions over 12 months; or (2) ¡Vida! plus Experiential Learning, which adds monthly Zoom sessions focused on cooking and physical activity. In Stage 2 (week 8), participants who lose 2% of baseline weight (measured via Fitbit Aria scale) are re-randomized to either continue the initial intervention or receive individualized health coaching using motivational interviewing or a Mailed Toolkit with culturally tailored shelf-stable foods, kitchen tools, and physical activity equipment. All participants receive a Fitbit Charge 6 and Aria scale for self-monitoring and have access to Cook for Your Life, a bilingual nutrition website for cancer survivors. Data are collected at baseline, 2, 6, and 12 months. A subset of participants provide ActiGraph data at each time point to assess physical activity patterns, and in-depth qualitative interviews will be conducted post-intervention. All components are offered in Spanish and English. Findings: As of June 24, 2025, 22 English-speaking participants have completed baseline assessments, and 14 Spanish-speaking participants have consented. The first intervention cohort will begin once 60–70 English-speaking participants are enrolled. Recruitment to date has been limited to the Washington State SEER registry, with expansion to California anticipated in summer 2025. However, the most common reason for ineligibility is BMI 30, and many SEER-provided phone numbers are unresponsive or inactive. In response, the BMI threshold was lowered to ≥27, and recruitment strategies are being broadened beyond SEER. Additionally, logistical issues with planned grocery delivery prompted a shift to Mailed Toolkits with shelf-stable foods and health-related equipment. Conclusions: The ¡Vida! trial has begun enrolling participants to test culturally tailored adaptive interventions to promote weight loss in Latina BC survivors. In response to recruitment and implementation challenges, the study team has adapted core components of the intervention and infrastructure to support broader reach and engagement. These early adaptations position the trial for future intervention effectiveness testing. Citation Format: Juan Gudino, Blake Langley, Jennifer Whitten, Yarizel Herrera, Kelley Nay, Sheryl Rothmuller, Sara Buzali, Jennifer Dearden, Sayan Dasgupta, Ashkan Ertefaie, Chongzhi Di, Nancy Davidson, Rachel Yung, India Ornelas, Heather Greenlee. ¡Vida! SMART Trial: Implementation readiness and early adaptation insights from a culturally tailored weight loss trial for Latina breast cancer survivors abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B099.
Gudino et al. (Thu,) studied this question.