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Part of the SNAP-Ed Strategies & Interventions Toolkit.*

Stay Strong, Stay Healthy (SSSH) is a direct education intervention designed to help older adults increase physical activity, decrease sedentary behaviors, increase fruit and vegetable consumption, and sustain physical activity participation and healthy eating behaviors post program. SSSH strives to meet the need for effective community-based physical activity (PA) and nutrition programs, so classes are offered by trained SSSH instructors in familiar locations such as churches, community centers, and senior centers. SSSH consists of 16 one-hour sessions over eight weeks. Participants complete a warmup, a prescribed set of upper- and lower-body strengthening exercises, and a cool-down. SSSH challenges participants through incremental increases in exercise volume and intensity. Each PA session is followed by a nutrition lesson, and lessons are tailored to older adults by addressing topics such as fiber, bone health, and vitamins and minerals for healthy aging. In addition to weekly group classes, participants are encouraged to complete the program on their own once a week, including preparation of the recipes. After the course ends, participants are still encouraged to continue at home or with a community group. The overall goal of SSSH is to increase PA and improve nutrition behavior to help seniors maintain independence.

University of Missouri Extension
SNAP-Ed Toolkit with a bike in the center of a blue circle with the yellow Toolkit* Strategy Banner
Funding Source
Free Material
Cost ($)
SNAP-Ed Toolkit Classification
  • Evaluated
Evaluation Information

A combination of pre/post health behavior data and post program surveys were collected immediately and three months post program. These data, both quantitative and qualitative, were used by an evaluation team to evaluate, modify, and improve SSSH, alongside feedback from other states who have adopted SSSH.  The team also conducted a randomized control trial (RCT) to better understand effectiveness of SSSH, including a quantitative phase to track physiologic change and a follow-up qualitative phase to explore perceptions of the impact on PA and changes in behaviors and attitudes. The trial indicated that participation in eight weeks of the SSSH resistance training program significantly improves lower body strength/coordination, dynamic balance, sleep quality, and engagement in auxiliary PA to a greater extent than an exercise volume matched walking group. These positive adaptations suggest that participation in the SSSH program reduces the risk for falls and can improve quality of life in previously sedentary older adults.

Furthermore, the results from participant pre/post surveys and pre/post assessments generate an annual impact report that outlines program outcomes, behavior changes made, and participant feedback testimonials. Multiple research studies have been conducted to support the effectiveness of the SSSH intervention, resulting in peer-reviewed publications and research posters that have been presented at various conferences on the benefits and outcomes of the program. Largely in part of these evidentiary findings, five other states have adopted SSSH and are implementing the program to SNAP-eligible audiences.

Evaluation Framework Indicators
SNAP-Ed Connection Comments

An implementing organization or agency must sign a license agreement to have access to the program protocol, evaluation and supporting materials. Implementing organization and agencies will need to purchase their own weights, scarves, and storage containers for certified instructors. Digital curriculum materials are included in the license cost. Printed copies are provided upon request at cost of printing.

*SNAP-Ed Strategies & Interventions: An Obesity Prevention Toolkit for States is a compilation of interventions. The toolkit was developed by USDA's Food and Nutrition Service, The Association of SNAP-Ed Nutrition Education Administrators (ASNNA), the University of North Carolina at Chapel Hill's Center for Training and Research Translation (Center TRT), and the National Collaborative on Childhood Obesity Research (NCCOR), a partnership between the Centers for Disease Control and Prevention (CDC), the National Institutes for Health (NIH), the Robert Wood Johnson Foundation, and the USDA. It is designed and updated to help state SNAP-Ed administrative and implementing agencies identify evidence-based obesity prevention programs and policy, systems, and environmental (PSE) strategies and interventions to include in their SNAP-Ed plans.

Review date