![](https://showme.missouri.edu/wp-content/uploads/2024/01/Steve-Ball-1_si_si.png)
For nearly 20 years, Stephen Ball has been a man on a mission: helping older Missourians stay healthy and get stronger through physical activity.
In 2005, the professor in the University of Missouri College of Health Sciences helped created a program called Stay Strong Stay Healthy (SSSH). Since then, the eight-week strength training program has helped more than 20,000 older adults across five states. Participants aged 60 and up are taught how to safely complete exercises — including squats, bicep curls and lunges — in a comfortable, friendly environment.
“One thing I always preach when it comes to physical activity is: some is better than none, more is better than some, and too much is difficult to get,” Ball said. “As the United States population is aging, I want to make a difference by helping older adults stay independent as they age and send the message that you don’t need an expensive gym membership with a personal trainer to stay active. We created a community-based program so older adults can exercise with others who look like them in a more comfortable, social environment.”
The MU Extension program has proven results. Participants consistently report an increase in physical energy and self-confidence, and multiple peer-reviewed studies and an extensive body of published literature show the program improves muscle strength, balance, flexibility and sleep. It’s also been proven to reduce participants’ risk for falling, a big concern for aging adults.
“Another benefit we often hear about is the social enjoyment participants have spending time with other older adults,” Ball said. “While it is certainly not expected, participants sometimes take the instructors out for lunch or ice cream after class as a sign of gratitude, appreciation and friendship.”
If some is good, more is better
The SSSH program begins with an introductory eight-week Level 1 class before participants can graduate to a more challenging eight-week Level 2 class. A recent study analyzed the effectiveness of the Level 2 class for more than 400 participants who completed the class in 78 counties throughout Missouri and Kansas over a three-year period. The findings showed that participants not only maintain the health benefits from Level 1 but also see additional improvement during Level 2.
“It’s gratifying to work with older adults because you really see them improve over time, and they quickly notice all the various health benefits,” Ball said. “As soon as they complete Level 1, they’re often asking how soon they can start Level 2.”
And the participants aren’t the only ones who benefit from the program. In addition to classes being taught by MU faculty, MU undergraduate and graduate students have the opportunity to lead sessions and develop soft skills such as relationship-building, leadership and teaching.
“I learned the importance of making the participants feel comfortable — a skill you can only really learn through experience — and I feel like I learned as much from the participants as they learned from me,” said Audrey Guess, an undergraduate student instructor majoring in health sciences. “I was originally thinking about a career in pediatrics, but now I think I want to continue to help older adults.”
Melaina Files, an undergraduate student instructor majoring in nutrition and exercise physiology, said the experience is one she won’t soon forget. “Becoming an SSSH program instructor was the most rewarding experience of my undergraduate career at MU,” she said. “I was so impressed by how much respect the participants had for us as instructors, and I appreciated hearing all of their life stories and wisdom.”
Building MOmentum
SSSH incorporates MU’s three main missions as a land-grant university: teaching, research and community outreach. In addition to teaching and conducting research at MU, Ball also serves as a state fitness specialist with MU Extension. He and Kelsey Weitzel, an associate extension professor and SSSH program manager, often travel across Missouri to teach MU Extension field faculty how to deliver the SSSH program to older adults in rural areas.
“We partner with research faculty at Oklahoma State University, and their extension network is now delivering SSSH to older adults in Oklahoma as well,” Ball said. “A few years ago, our SSSH program was named as an “evidence-based program” by the federal government’s Supplemental Nutrition Assistance Program (SNAP). This designation allows for the use of federal funds to deliver SSSH to eligible audiences.”
Going forward, Ball plans to apply for evidence-based status from the National Council on Aging (NCOA). This designation would open the door for additional funding to deliver SSSH nationally, especially to help older adults reduce their risk of falling so that they can maintain independence as they age.
“We are proud of our impact so far, and we’re just getting started,” Ball said. “Because of the popularity and success of our program, we’re piloting a Level 3 class to help participants continue their forward momentum. Not only are we changing the lives of the participants by improving their health as they age, we are also providing professional development opportunities for our students at MU as well.”
“Improving older adults’ functional health using the progressive Stay Strong, Stay Healthy program” was published in the Journal of Applied Gerontology.