The First Step Program uses simple and inexpensive pedometers to incrementally increase walking behaviors in sedentary individuals with type 2 diabetes. The pilot sample consisted of nine individuals (six women, three men; group mean age 53+/-6; group mean body mass index=32.9+/-3.4kg/m(2)). A timed self-paced walk while wearing the pedometer allowed for the conversion of changes in pedometer steps per day to time in minutes per day. There was an immediate and dramatic increase in walking behavior (an average of 34.3min of walking a day) that was sustained even 2 months post-intervention and after withdrawal of contact (an average of 22.6min of walking a day). Improvements in other outcomes (systolic blood pressure and waist girth) support a valid change in behavior. Although preliminary, these results warrant further investigation of such approaches.