My research is focused on examining risk behaviors and health outcomes among children, adolescents, and young adults with special health care needs. Recently our research team conducted studies examining parent and child reported outcomes and health care expenditures associated with integrated curative and palliative care programs for children with life-limiting conditions, including those with cancer. Several papers developed from this work are in press in the Journal of Palliative Medicine and the Journal of Palliative Care. As part of our health outcomes research, our team is focused on the development of health related quality of life measures for young adult survivors of childhood and adolescent cancer. We are collaborating with investigators involved in the NIH Patient Reported Outcomes Measurement Information System (PROMIS) initiative on this portion of our work. We also are collaborating with the UF Cancer Survivors Program (CSP) to examine health care outcomes among young adult survivors. In a prior U01 from the Agency for Health Care Research and Quality, our team examined health risk behaviors among low-income adolescents and their self-reported experiences with anticipatory guidance provided by their primary care physicians. As part of our research, we found that risky behaviors were particularly high among adolescents with special health care needs, including those with cancer, when compared to healthy adolescents. Moreover, those with special needs were less likely to report receiving recommended anticipatory guidance about risk behaviors during health care visits than those who were healthy. Our ultimate goal, through this research, is to develop better screening and prevention programs to promote healthy behaviors for all adolescents but especially for those with special health care needs. Our research in this area is being applied to the young adult survivor group to examine their risky behaviors (e.g., smoking, unprotected sex, substance use, failure to seek health care) and to develop health promotion programs for them.