BACKGROUND: Our data have indicated that minority breast cancer survivors are receptive to participating in lifestyle interventions delivered via email or the web, yet few web-based studies exist in this population. OBJECTIVE: The aim of this study was to examine the feasibility and preliminary results of an email-delivered diet and activity intervention program, "A Lifestyle Intervention Via Email (ALIVE)", delivered to a sample of racial and ethnic minority breast cancer survivors. METHODS: Survivors (mean age 52 years, 83% (59/71) African American) were recruited and randomized to receive either the ALIVE program's 3-month physical activity track or its 3-month dietary track. The fully automated system provided tools for self-monitoring and goal setting, tailored content, and automated phone calls. Descriptive statistics and mixed-effects models were computed to examine the outcomes of the study. RESULTS: Upon completion, 44 of 71 survivors completed the study. Our "intention-to-treat" analysis revealed that participants in the physical activity track made greater improvements in moderate to vigorous activity than those in the dietary track (+97 versus +49 min/week, p < 0.001). Similarly, reductions in total sedentary time among those in the physical activity track (-304 versus -59 min/week, p < 0.001) was nearly 5 times greater than that for participants in the dietary track. Our completers case analysis indicated that participants in the dietary track made improvements in the intake of fiber (+4.4 g/day), fruits and vegetables (+1.0 cup equivalents/day), and reductions in saturated fat (-2.3 g/day) and trans fat (-0.3 g/day) (all p < 0.05). However, these improvements in dietary intake were not significantly different from the changes observed by participants in the physical activity track (all p > 0.05). Process evaluation data indicated that most survivors would recommend ALIVE to other cancer survivors (97%), were satisfied with ALIVE (82%), and felt that ALIVE was effective (73%). However, survivors expressed concerns about the functionality of the interactive emails. CONCLUSIONS: ALIVE appears to be feasible for racial and ethnic minority cancer survivors and showed promising results for larger implementation. Although survivors favored the educational content, a mobile phone app and interactive emails that work on multiple email domains may help to boost adherence rates and to improve satisfaction with the web-based platform. TRIAL REGISTRATION: ClinicalTrials.gov NCT02722850; https://ClinicalTrials.gov/ct2/show/NCT02722850.

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