The 5-4-3-2-1 go! Brand to promote nutrition and physical activity: a case of positive behavior change but negative change in beliefs.

In recent years, community-based obesity prevention programs have taken an ecological approach and addressed social determinants of obesity. The branded 5-4-3-2-1 Go! obesity prevention program aims to change obesity risk behaviors in low-income neighborhoods in Chicago with a multilevel approach. This study follows a previous evaluation, which showed 5-4-3-2-1 Go! exposure to be associated with increased fruit and vegetable consumption. The authors examined whether increased positive beliefs about fruit and vegetable consumption were associated with exposure to program messages. Exploratory factor analysis identified a fresh fruit/vegetable availability satisfaction factor. The authors compared outcome measures between baseline and follow-up samples and between exposure and control conditions. Multivariable logistic regression models were estimated to evaluate the effects of program exposure on changes in nutrition beliefs. The study found that participants' (n = 246) beliefs about fruit and vegetable consumption were negatively associated with exposure to the program and that demographic factors, social environment, and physical environment were strongly associated with beliefs about fruit and vegetable consumption. These findings merit further research and may indicate the environmental factors that are associated with attitude formation among those reached by obesity prevention interventions, especially when many participants live in neighborhoods lacking convenient fruit and vegetable shopping options.