This study identified program delivery preferences and barriers to physical activity and healthy eating. Ninety-nine urban dwelling American Indians completed a questionnaire at powwows, community events, and a community health center. Most frequently selected program delivery preferences were coaching or other human contact, with fewer willing to use computer or telephone coaching. Fifty-six selected attending 8, 12, or 16 sessions. Most frequently selected barriers to physical activity were lack of time ( n = 48) and pain from existing problems ( n = 33). Frequently identified barriers to eating healthy foods included expense ( n = 42), uncertainty regarding what foods are healthy ( n = 25), extra time needed for preparation ( n = 22), and lack of knowledge of how to prepare healthy food ( n = 22). Findings showed the need for programs to focus on decreasing the barriers of time for physical activity and healthy eating and encourage doing organized physical activity (not necessarily exercise) with others to increase physical activity.