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• The Promoting Physical Activity in Regional and Remote Cancer Survivors (PPARCS) intervention produced a significant net increase of 50 min/week of moderate-to-vigorous physical activity (MVPA) favoring the intervention. • PPARCS is the first trial to demonstrate preliminary effectiveness of a low-intensity, distance-based intervention for increasing MVPA in non-metropolitan breast and colorectal cancer survivors (standardized mean difference = 0.56). • The intervention demonstrates feasibility in terms of reach and acceptability in terms of high levels of engagement. • Given the low-intensity nature of the intervention and limited resources required (i.e., wearable tracker and phone support), PPARCS would appear to be scalable and could potentially be scaled up and delivered through existing infrastructure such as Cancer Councils nationwide. Physical activity (PA) is important for cancer survivors. Trials of remotely delivered interventions are needed to assist in reaching under-served non-metropolitan cancer survivors. The objective of this study was to ascertain whether wearable technology, coupled with health coaching was effective in increasing PA in breast and colorectal cancer survivors living in regional and remote areas in Australia. Cancer survivors from 5 states were randomized to intervention and control arms. Intervention participants were given a Fitbit Charge 2TM and received up to 6 telephone health coaching sessions. Control participants received PA print materials. Accelerometer assessments at baseline and 12 weeks measured moderate-to-vigorous PA (MVPA), light PA, and sedentary behavior. Eighty-seven participants were recruited (age = 63 ± 11 years; 74 (85%) female). There was a significant net improvement in MVPA of 49.8 min/week, favoring the intervention group (95% confidence interval (95%CI): 13.6–86.1, p = 0.007). There was also a net increase in MVPA bouts of 39.5 min/week (95%CI: 11.9–67.1, p = 0.005), favoring the intervention group. Both groups improved light PA and sedentary behavior, but there were no between-group differences. This is the first study to demonstrate that, when compared to standard practice (i.e., PA education), a wearable technology intervention coupled with distance-based health coaching, improves MVPA in non-metropolitan cancer survivors. The results display promise for the use of scalable interventions using smart wearable technology in conjunction with phone-based health coaching to foster increased PA in geographically disadvantaged cancer survivors. [Display omitted] [ABSTRACT FROM AUTHOR]