The Active Living After Cancer (ALAC) program was designed to help survivors of breast cancer engage in physical activity. A new study, with results published in the journal Cancer, aimed to assess an adaptation of the ALAC program to medically underserved and minority populations of breast cancer survivors.

Physical activity is associated with many positive benefits related to quality of life after a breast cancer diagnosis and reductions in overall and breast cancer-related mortality. However, they noted, survivors of cancer frequently do not meet physical activity recommendations.

“The ALAC program is an innovative approach to increasing activity that promotes home-based exercise and encourages lifestyle changes by setting personalized and achievable goals,” the investigators wrote in their report. 

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The ALAC program involves weekly group sessions that include brief physical activity, training in cognitive and behavior skills, and content related to cancer survivorship. Survivors were adults who had breast cancer and who had finished their primary cancer treatments. 

For this study, program adaptations included health educators and participants were selected from the community with outreach to the underserved; 20-hour program was reduced to 12 hours; program materials were simplified, included photos of people of mixed races/ethnicities, and was translated into Spanish; and the evaluation was simplified to 2 functioning tests to maximize completion and minimize the time taken from program activities. 

Participants’ physical activity, physical functioning, and quality of life were assessed at baseline and at 12-week follow-up. Physical functioning was measured using a 6 minute walk test and a 30-second sit-to-stand test. Patients also completed surveys at follow-up related to mastery of program content and satisfaction with the program.

The analysis included 127 survivors who completed the program and follow-up. The mean level of moderate-to-vigorous physical activity at baseline was 172.8 minutes/week (standard deviation [SD], 328.4) and increased to 344.6 minutes/week (SD, 386.8) at 12-week follow-up (P <.01). Mental and physical quality of life also improved overall between baseline and follow-up (P <.01 for each comparison). 

Distances on the 6-minute walk test improved from a mean of 427.8 m (SD, 80.7) at baseline to 469.9 m (SD, 98.3) at follow-up (P <.01). The number of repetitions in the 30-second sit-to-stand test increased from a mean of 12.5 (SD, 4.2) at baseline to a mean of 14.9 (SD, 5.2) at follow-up (P <.01). 

The level of participant satisfaction with the program was 98%, and 98% of participants reported they would recommend the program to other cancer survivors. Self-reports of program outcomes indicated 97% felt the program helped with their physical activity, with most reporting it helped them feel better physically (92%) and emotionally (83%).

“The significant changes in participant outcomes and the high levels of program content mastery and satisfaction indicate that the adaptations made to the evidence-based program were successful and did not compromise effectiveness,” the investigators concluded.


Tami-Maury IM, Liao Y, Rangel ML, et al. Active living after cancer: adaptation and evaluation of a community-based physical activity program for minority and medically underserved breast cancer survivors. Cancer. Published online September 23, 2021. doi:10.1002/cncr.33904