In developed countries such as the United States, adolescent health risk behaviors are monitored for trends and the resulting data serves as the basis for effective interventions and policies. During adolescence, individuals achieve the final 15-20% of their height, gain 50% of their adult body weight, and accumulate up to 45% of their skeletal mass. In addition, most people develop and exhibit certain health risk behaviors during this time. Currently, 85% of the world's adolescent populations live in developing countries, yet because of lack of comprehensive programs, there is a gap in data on the health risk behaviors of this important population segment. Through the STEPwise approach to Risk Factor Surveillance (STEPS), the World Health Organization's is working on bridging the data gap. As part of the STEPS program, in 2001, the Global School-Based Student Health Survey (GSHS) was developed through a collaboration involving WHO, and CDC. The GSHS will help fill the gap in health data as it relates to adolescent health behavior in developing countries. However, to date, only 13 of the 42 countries in Africa have initiated GSHS activities. Four countries have completed and submitted final GSHS reports. In 2006, Middle Tennessee State University (MTSU), the World Health Organization (WHO), the United States Centers for Disease Control and Prevention (CDC) in conjunction with the Ministry of Education, Science and Sports in Ghana, established a partnership to implement the GSHS in Ghana. Ghana is a developing country in West Africa with a population of 22.1 million and approximately 40% of the population is under 15 years of age. Unlike most African countries, Ghana has enjoyed the benefits of an economic resurgence with a Gross Domestic Product growth rate of 5.8% in 2004. This GSHS surveillance effort will help concerned entities in Ghana by; 1) helping develop priorities, establish programs, and advocate for resources; 2) establishing trends in the prevalence of health behaviors and protective factors and; 3) allowing Ghana and international agencies to make comparisons across countries. The GSHS consists of 10 core questionnaire modules of which 9 will be used in Ghana. Using a 2 stage cluster sampling approach, 75 sample schools out of over 8000 eligible schools has been selected. This represents 5765 participants between the ages of 13 and 15 out of 1.03 million eligible students. A final research report is expected to be completed by fall 2008. Keyword(s): assessment, disease prevention/wellness, youth-at-risk