Since 2008 Out, Proud and Healthy has been conducting LGBT health needs assessments annually at Pride events across Missouri. We have been able to build deliberate research strategies allowing us to collect more than 10,000 surveys representing the voices of sexual and gender minorities across the state. Our research uses a multi-modal data collection approach (at pride festivals and online) and was supplemented with focus group data. Additionally, the voices of racial and ethnic minorities within the LGBTQ community are represented in our datasets. This has allowed Out, Proud and Healthy to generate historic reports about LGBT demographics, tobacco use, alcohol use, fitness, mental health and health disparities in general.