As part of the Cycle II program of research, the Hub will expand its focus to include potential cognitive impacts associated with air pollution exposure. Research suggests higher prenatal or concurrent exposure to outdoor air pollution is associated with poorer performance on measures of children’s cognition, attention, executive function (EF), and academic skills, possibly mediated through effects on brain structure and function. Prior findings link self-regulation, a key EF, to academic achievement, suggesting that associations between air pollution and academic achievement are mediated via self-regulatory processes.
A sub-study of the Eastern Africa Children’s Health (EACH) Study, the Cognitive Performance Assessments Study, will be conducted to assess 1) performance on the Kenya Certificate of Primary Education examination to measure academic achievement for the entire EACH study population in Kenya, and 2) detailed assessments that researchers will administer to a cohort of 300 children drawn from the EACH study population in Kenya. These 300 participants will also be those who will receive personal air pollution exposure assessments as part of the Personal Air Pollution Exposure Assessment Study. For the entire EACH study population in Kenya, researchers will examine results of the mathematics and language subject area tests of the Kenya Certificate of Primary Education examination as the primary outcome variable. In the subsample of 300 children for whom personal exposure assessments will be performed, researchers will administer a brief tablet-based battery of attention and executive function tests and behavioral assessment surveys. Attention and executive function will be assessed using National Institute of Health Toolbox tests: Flanker Inhibitory Control and Attention Test for ages 12+, which measures attention and inhibitory control, and the Dimensional Change Card Sort Test for ages 12+, which measures cognitive flexibility. To assess behavior, we will use the Child Behavior Checklist (CBCL) for ages 6-18 years. Behavior reports of study participants will be collected from their parents and teachers as well as self-reports from participants. The primary outcome will be attention problems and attention deficit/hyperactivity problems, with the other scales and reporters as secondary outcomes.
The Cognitive Performance Assessments Study will be initiated in conjunction with the EACH study by Hub researchers at University of Nairobi, Kenya for a period of one year between 2023-2026.