The purpose of this study is to examine the social and communicative barriers LGBTQIA+ students face when seeking healthcare at campus health and counseling services at Arizona State University. Social barriers relate to experiences and internalizations of societal stigma experienced by sexual and gender minority individuals as well as the anticipation of such events. Communication between patient and provider was assessed as a potential barrier with respect to perceived provider LGBTQIA+ competency. This study applies the minority stress model, considering experiences of everyday stigma and minority stress as a predictor of healthcare utilization among sexual and gender minority students. The findings suggest a small but substantial correlation between minority stress and healthcare use with 23.7% of respondents delaying or not receiving one or more types of care due to fear of stigma or discrimination. Additionally, communication findings indicate a lack of standardization of LGBTQIA+ competent care with experiences varying greatly between respondents.

The epidemic of overweight and obesity and its multiple causes have captured the attention of researchers, program administrators, politicians, and the public alike. Recently, many stakeholder groups have started investigating the role that food and nutrition assistance programs play in the etiology of the problem and in identifying possible solutions. As a result, policy changes have been recommended and implemented for programs such as the National School Lunch Program (NSLP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to improve the nutritional quality of foods they offer to their participants. The Supplemental Nutrition Assistance Program (SNAP) is also attracting attention as a potential vehicle to reduce the burden of obesity among its users. Because of the tough economic and political climate in which all federal programs currently operate, the need for making nutrition assistance programs more efficient and effective in addressing health and nutrition related problems affecting the country has never been greater.

This document proposes a set of strategies to improve the effectiveness and efficiency of SNAP. These strategies are based on a review of research literature, recommendations from expert groups, and the experiences of other communities and states. We include information that pertains to potential stakeholder arguments for and against each strategy, as well as the political feasibility, financial impact, and logistical requirements for implementation. We drew candidate strategies from the range of options that have been tested through research and from policies that have been implemented around the country. The order of strategies in this document is based on overall strength of supportive research, as well as political and implementation feasibility. The four proposed strategies are improving access to healthy foods to provide better choices, incentivizing the purchase of healthy foods, restricting access to unhealthy foods, and maximizing education to more effectively reach a larger population of SNAP participants.