TITLE: Transition and Health Implications of Posttraumatic Growth in Pediatric Cancer Survivors PROJECT SUMMARY/ABSTRACT: As the number of pediatric cancer survivors increases, it is crucial to ensure that survivors receive guideline-based follow-up care to mitigate late effects and screen for secondary malignancies and recurrence. Nationally established survivorship care guidelines emphasize the importance of (1) attending yearly, guideline-based survivorship care and (2) engaging in positive health behaviors, including eating a well-balanced diet and being physically active. Several barriers may exist that inhibit young adult pediatric cancer survivors from following these care guidelines. For example, pediatric cancer survivors are at risk for the development of posttraumatic stress symptoms, which can lead to avoidance and inhibition of positive health behaviors. However, survivors may also endorse posttraumatic growth (PTG), and previous qualitative and quantitative studies suggest PTG may be positively correlated with positive health behaviors in cancer survivors. Despite these optimistic findings, no studies to date have investigated the role of PTG in survivorship care transition and engagement in positive health behaviors in pediatric cancer survivors. The proposed project aims to inform prevention efforts targeting pediatric cancer survivors by investigating 1) a qualitative perspective of the psychological and behavioral components of posttraumatic growth for survivors, 2) the relationship between PTG and successful transition to adult survivorship care and 3) the relationship between PTG and positive health behaviors. This study will investigate potential positive implications of PTG in pediatric cancer survivors, with the goal of informing intervention development. Participants will be asked to complete a semi-structured interview, a PTG measure, a dietary recall measure and a physical activity recall measure. Participants will be recruited from a Pediatric Cancer Survivorship Registry, an existing research- consenting patient database developed by the University of Kansas Medical Center and Children’s Mercy Kansas City to follow survivors of pediatric cancer during their transition from pediatric to adult survivorship care. This study seeks to follow thoughtful, strategic steps to involve individuals from groups that are typically underrepresented in cancer research. The proposed study aims are integrated with a specialized training plan designed to improve the applicant’s knowledge of pediatric cancer survivorship, trauma, behavioral health intervention development and health equity. The proposed research project and training plan will provide vital support for the applicant’s development as an independent translational researcher.