Abstract
Background/Objectives: Robust, state-level LGBTQ+ health surveillance is scarce in Kentucky, limiting evidence-based healthcare planning and policy. We aimed to evaluate the feasibility and early public-health utility of a community-partnered annual survey and compare selected mental health stressors between Kentucky and non-Kentucky respondents. Methods: We conducted a cross-sectional online survey (13 April-15 July 2024) developed with a statewide LGBTQ+ nonprofit. Recruitment occurred via organizational channels and community events. A content warning preceded the survey, which was administered via Qualtrics. Data quality was screened using reCAPTCHA. We assessed feasibility metrics including recruitment and completion rates. Mental health stressors were captured with a six-item scale. Group differences were estimated with Welch's t-tests. Results: Of 3852 survey starts, 1559 were retained as analyzable completes (completion rate: 40.47%), with 78.7% residing in-state. Initial analysis revealed a significant divergence in mental health patterns: while Kentucky participants reported lower stress regarding their personal mental health, they reported significantly higher stress stemming from socio-political issues like homophobia and transphobia compared to out-of-state respondents. Conclusions: An annual, community-partnered surveillance platform is a feasible strategy for generating actionable mental health signals relevant to healthcare. These findings will inform targeted outreach and guide health system partnerships to enhance LGBTQ+-affirming care in Kentucky.