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Compared to other ethnicities, American Indians have higher rates of obesity and are disproportionately diagnosed with comorbid diseases such as diabetes, high blood pressure, and heart disease. While genetic, behavioral, and social risk factors contribute to health disparities and disease, the concept of self-efficacy, an element of Bandura’s social cognitive theory, influences the ability to overcome barriers and reduce risk. When combined with the health belief model, this theory also provides the foundation for understanding perceptions, attitudes, and beliefs about disease. Yet, research in these areas is limited for American Indians. Therefore, the purpose of this cross-sectional survey study was to examine cooking techniques and meal preparation self-efficacy, negative cooking attitude, self-efficacy for eating and cooking with fruits and vegetables, health value, and perceived severity, susceptibility, barriers and benefits on body mass index (BMI) for 92 American Indians in Maricopa County, Arizona. Participants self-reported height and weight to calculate BMI and completed the Cooking with a Chef Evaluation Instrument and the Health Belief Model Scale in Obesity. Quantitative data were analyzed by multiple regression analysis and the combination of all predictors had a statistically significant large effect on BMI prediction. Health value and self-efficacy for cooking techniques and meal preparation were each statistically significant predictors with small effects. Clinicians, physicians, tribal authorities, and researchers may benefit from this study’s results by understanding the impact of self-efficacy and health perceptions on BMI to promote positive social change for health equity within American Indian communities.