Background. Physical activity exerts cancer-protective effects, yet most Americans are inactive, especially in the South, where cancer incidence rates are generally higher. Telephone-based approaches can help overcome physical activity intervention barriers in this region (literacy, costs, lack of transportation/technology, distance from facilities) and can be automated via interactive voice response (IVR) systems for improved reach and cost-effectiveness. Aims. To evaluate the Deep South IVR-supported Active Lifestyle (DIAL) intervention. Method. A pilot randomized controlled trial was conducted among 63 underactive adults in Birmingham, Alabama, from 2015 to 2017. Results. Retention was 88.9% at 12 weeks, and ≥75% adherence (IVR contact on at least 63 out of 84 days) was noted among 62.5% of intervention participants. Intervention participants reported larger increases in self-reported minutes of moderate-to-vigorous intensity physical activity from baseline to 12 weeks than the wait-list control arm (median change = 47.5 vs. 5.0 minutes, respectively, p =.09). Moreover, the intervention produced significantly greater increases in physical activity self-regulation (p <.001) and social support from family (p =.001) and friends (p =.009) from baseline to 12 weeks, compared with the wait-list control. Significant decreases in self-reported sleep disturbance also were found in the intervention arm but not among the controls, p <.05. Overall, intervention participants reported being satisfied with the DIAL program (71.4%) and would recommend it to friends (92.9%). Discussion. Findings support the feasibility, acceptability, and preliminary efficacy of the DIAL intervention. Conclusion. Next steps include intervention refinement in preparation for a fully powered efficacy trial and eventual dissemination to rural counties.