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  1. Len Xen Mei, ThavamalarParamasivam, Ng Siow Fam, Lim Pek Hong, Fong Ka Ling, Mohammed Abdul Razzaq Jabbar, et al.
    MyJurnal
    Introduction: Studies found that low sleep quality (SQ) is associated with many factors such as health, quality of life (QOL), work or academic performance and co-curriculum activities. Hence, improvement to maintain SQ to en- hance students’ QOL is important. Approximately 43% of Malaysian were unaware of their sleep problem and how it affects their physical and mental health, especially among the younger generation. The study aims to investigate the association between SQ and QOL among undergraduate students in UTAR Sungai Long Campus. Method: A cross-sectional study among 256 undergraduate students recruited by purposive sampling was conducted. The Pitts- burgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life Instruments (WHOQOL-BREF) were administered to evaluate SQ and QOL, respectively. Self-reported demographic data were collected with a structured sociodemographic profile. Associations were evaluated using Spearman’s correlation coefficient, Chi- square test and independence t-test. The level of significance was p< 0.05. Result: Results showed more than one half of students had poor SQ (F=137, 53.5%) and poor QOL (F= 159, 62.1%). All seven PSQI components were significantly associated with at least one QOL domain. Sleep disturbances, sleep latency and daytime dysfunction were correlated with all four QOL domains which are physical health, psychological, social relationships, and envi- ronment. Among the sociodemographic variables, only time travelled from place of stay to campus was associated to SQ (p = 0.04). However, there was no significant association between SQ and the selected sociodemographic vari- ables such as gender, working part-time job, and travel distance from place of stay to campus. Conclusion: Overall, the results from this study showed one half of students suffered from poor SQ and QOL. SQ among undergraduate students is vital in developing good QOL.
  2. Mohd-Sidik S, Lekhraj R, Foo CN
    PMID: 33498401 DOI: 10.3390/ijerph18030868
    BACKGROUND: The pervasiveness of obesity is a growing concern in the world. This study aims to determine the prevalence of obesity among a segment of the Malaysian population, as well as investigate associated factors and psychological determinants of obesity.

    METHODS: A cross-sectional study design was carried out in Selangor, Malaysia. A total of 1380 Malaysian adults (≥18 years old) participated in a structured and validated questionnaire survey. TANITA body scale and SECA 206 body meter were used to measure the respondents' weight and height, from which measurements of their body mass index (BMI) were calculated.

    RESULTS: The overall prevalence of obesity (BMI ≥ 30 kg/m2) among adults in Selangor, Malaysia, was 18.6%. Factors significantly associated with increased risk of obesity were: being female (OR = 1.61, 95% CI [1.20-2.17]), aged between 30 to 39 years old (OR = 1.40, 95% CI [1.04-1.88]), being Indian (OR = 1.55, 95% CI [1.13-2.12]), married (OR = 1.37, 95% CI [1.03-1.83]), and having only primary school education (OR = 1.80, 95% CI [1.17-2.78] or secondary school education (OR = 1.37, 95% CI [1.04-1.81]). In the multiple linear regression analysis (stepwise method), perceived stress (B = -0.107, p = 0.041), suicidal ideation (B = -2.423, p = 0.003), and quality of life in the physical health domain (B = -0.350, p = 0.003) inversely and significantly contributed to BMI among males. Among females, stressful life events contributed positively to BMI (B = 0.711, p < 0.001, whereas quality of life in the psychological domain had a negative effect (B = -0.478, p < 0.001) in this respect.

    CONCLUSION: There is an urgent need to integrate psychological approaches to enhance the effectiveness of obesity prevention strategies and weight-loss programs.

  3. Kiruthika S, Tan LF, Foo CN
    PMID: 39156233 DOI: 10.51866/oa.521
    INTRODUCTION: Differentiating between migraine and COVID-19 headaches is essential for better treatment. Evidence-based research during the COVID-19 pandemic has found that university students are more likely to experience migraine. Migraine can affect academic performance, sleep pattern, social and emotional well-being if left untreated or misdiagnosed. This study aimed to determine the prevalence of migraine symptoms and the association of triggers, coping strategies and clinical characteristics with COVID-19 diagnosis.

    METHODS: This cross-sectional study was conducted across higher educational institutions in Peninsular Malaysia. Convenience sampling was applied to recruit full-time university students. A reliable and validated instrument was used to evaluate demographic data, migraine symptoms, triggers, coping strategies and clinical characteristics of migraine (frequency, intensity, severity and duration) during COVID-19 diagnosis.

    RESULTS: The response rate was 98.3%, where 485 out of 493 responses were analysed. The prevalence of migraine was 35.9% (n=174). None of the triggers, coping strategies and clinical characteristics of migraine were significantly associated with COVID-19 diagnosis.

    CONCLUSION: The university students in Peninsular Malaysia showed a considerable prevalence of migraine symptoms. During the pandemic, the common triggers for existing symptoms were stress and a lack of sleep (combined triggers). The coping strategy adopted by most of the university students was lifestyle changes and in the COVID-19 positive group maladaptive coping strategies were adopted indicating the need for further investigation.

  4. Alkharji H, Gan QF, Foo CN
    Iran J Public Health, 2022 Nov;51(11):2449-2457.
    PMID: 36561259 DOI: 10.18502/ijph.v51i11.11162
    Stroke remains a leading cause of adult disability, and it decreases the health-related quality of life due to functional disability and poor functional recovery in stroke. Tai Ji has been recently introduced to overcome disabilities. This review aims to explain the effects of Tai Ji on functional recovery in stroke patients, linking it to current approaches, concepts and therapies such as Bobath and proprioceptive neuromuscular facilitation techniques. A compilation of recent literature on Tai Ji's use in stroke rehabilitation from Google scholar and PubMed Central (2018 to 2022). The benefits of Tai Ji in stroke functional recovery were studied and explained based on its similarity in concepts to current conventional stroke rehabilitation approaches. There were few randomized controlled trials on Tai Ji in functional recovery among stroke patients. However, all literature identified Tai Ji as beneficial in stroke rehabilitation. However, there was no literature on explaining the Tai Ji movement based on current conventional stroke rehabilitation approaches. Tai Ji carries similar theories to the current neurorehabilitation approach. Tai Ji can be modified and incorporated into stroke rehabilitation programs based on patients' needs to produce promising outcomes.
  5. Foo CN, Arumugam M, Lekhraj R, Lye MS, Mohd-Sidik S, Jamil Osman Z
    PMID: 32858791 DOI: 10.3390/ijerph17176179
    BACKGROUND: Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia.

    METHODS: A parallel-group unblinded randomized controlled trial involving 300 patients was conducted in two hospital orthopedics clinics in Malaysia. Patients were randomly assigned to receive cognitive behavioral-based group therapy (n = 150) or no further intervention (n = 150). The primary outcome was the change from baseline in knee pain as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 months. The data collected were analyzed by covariate-adjusted mixed design repeated measures analysis of variance. All analyses were performed under the terms of intention-to-treat.

    RESULTS: At 6 months, mean change from baseline in the KOOS knee pain score was 0.6 points (95% CI -1.73 to 2.94) in the control group and 8.9 points (95% CI 6.62 to 11.23) (denoting less knee pain intensity) in the intervention group (significant treatment effect p < 0.0001). Patients treated with such an approach also experienced significant improvement in functional ability when performing activities of daily living and had improved ability to cope with depression, anxiety and pain catastrophizing.

    CONCLUSION: The intervention module delivered by healthcare professionals had a sustained effect on knee OA pain and functionality over 6 months, thereby leading to an overall improvement in psychological well-being, thus benefitting most of the Malaysian knee OA patients.

  6. Jaffar A, Mohd Sidik S, Foo CN, Muhammad NA, Abdul Manaf R, Fadhilah Ismail SI, et al.
    PMID: 33946203 DOI: 10.3390/ijerph18094792
    BACKGROUND: The delivery of pelvic floor muscle training (PFMT) through mHealth apps has been shown to produce promising results in improving pelvic floor muscle strength and urinary incontinence (UI). However, there is limited evidence on mHealth apps designed for pregnant women who are at high risk of developing UI. This pilot study aims to evaluate the feasibility of conducting an effectiveness trial for a newly developed PFMT app among pregnant women in Malaysia.

    METHODS: This is a prospective, single-centre, single-blind, randomised controlled pilot feasibility study: The Kegel Exercise Pregnancy Training app (KEPT-app) Trial. Sixty-four incontinent pregnant women who attended one primary care clinic for the antenatal follow-up will be recruited and randomly assigned to either intervention or waitlist control group. The intervention group will receive the intervention, the KEPT-app developed from the Capability, Opportunity, Motivation-Behaviour (COM-B) theory with Persuasive Technology and Technology Acceptance Model.

    DISCUSSION: This study will provide a fine-tuning for our future randomised control study on the recruitment feasibility methods, acceptability, feasibility, and usability of the KEPT-app, and the methods to reduce the retention rates among pregnant women with UI.

    TRIAL REGISTRATION: This study was registered on ClinicalTrials.gov on 19 February 2021 (NCT04762433) and is not yet recruiting.

  7. Poo CL, Dewadas HD, Ng FL, Foo CN, Lim YM
    J Pain Symptom Manage, 2021 07;62(1):159-173.
    PMID: 33278502 DOI: 10.1016/j.jpainsymman.2020.11.024
    CONTEXT: Traditional Chinese Medicine (TCM) has been widely used as a complementary medical treatment for arthralgia and other types of pain. The available literature on the effectiveness of TCM on breast cancer patients with musculoskeletal symptoms reports controversial results.

    OBJECTIVES: The objective of this review is to assess the effectiveness of TCM as a treatment option for musculoskeletal symptoms in patients with breast cancer who were treated with aromatase inhibitors (AIs).

    METHODS: A comprehensive literature search was conducted using PubMed, the Cochrane Library, SAGE journals, Scopus, EMBASE, Web of Science, Medline, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Wanfang, and Chinese Medical Journal Database (CMJ) from May 2020 to November 2020. The literature review included randomized controlled trials (RCTs) of TCM for AI-related musculoskeletal symptoms.

    RESULTS: Four RCTs incorporating TCM were assessed by meta-analysis and reported favorable effects in reducing worst pain score (n = 284, mean difference [MD]: 2.31; 95% CI, 1.74 to 2.88; P 

  8. Jaffar A, Mohd-Sidik S, Abd Manaf R, Foo CN, Gan QF, Saad H
    PLoS One, 2021;16(4):e0250714.
    PMID: 33909678 DOI: 10.1371/journal.pone.0250714
    BACKGROUND: Pregnant women have an increased risk of urinary incontinence (UI), affecting their quality of life (QoL). This study aims to determine UI and its relationship with QoL among incontinent pregnant women.

    METHODS: This was a cross-sectional study in a semi-urban primary care clinic in Selangor, Malaysia, among pregnant women aged 18 years old and above. The validated study instruments consisted of questions on socio-demography, the International Consultation on Incontinence Questionnaire-UI Short Form (ICIQ-UI SF) to determine UI and the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSQoL) to assess their QoL. A generalised linear model was used to determine the association between the continent and incontinent pregnant women with QoL.

    RESULTS: Of the approached 610 respondents, 440 consented to participate in the study, resulting in a response rate of 72.1%. The mean age was 29.8 years old (SD 4.69) with 82.2% (n = 148) having stress UI. Significant independent factors related to the decreased QoL were mid to late trimester (OR 3.06, 95% CI 1.48-6.32), stress UI, (OR 6.94, 95%CI 4.00-12.04) and urge UI (OR3.87, 95%CI 0.48-31.28). Non-Malay improved QoL (OR 0.29, 95% CI 0.16-0.52).

    CONCLUSIONS: All types of UI significantly affecting pregnant women's QoL. This information is useful in enhancing antenatal management at the primary care level, whereby they should be screened for UI and provided with effective early intervention to improve their QoL.

  9. Foo CN, Manohar A, Rampal L, Lye MS, Mohd Sidik S, Osman ZJ
    MyJurnal
    Introduction: Osteoarthritis (OA) is the main cause of knee pain. It also affects individual’s physical functioning. Anti- inflammatory drugs and knee replacement are the mainstay methods in the management of knee OA in Malaysia. However, patients with knee OA often suffer pain. The general objective of the study is to evaluate the effectiveness of a cognitive behavioural intervention module on knee pain, functional disability and psychological outcomes among knee OA patients attending Orthopedics Clinics in Hospital Putrajaya and Hospital Serdang, Malaysia. This study aims to determine the baseline level of knee pain and functional disability among knee OA patients.
    Methods: Baseline results on the knee pain and functional disability were obtained from a two arm parallel- group randomized controlled study. Three hundred patients aged 35 to 75 years diagnosed with knee OA were recruited. A set of pre tested and validated Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire was used in this study.
    Results: Mean baseline of KOOS pain was 56.09 (SD=21.75) and 52.26 (SD=22.08) for the intervention and control groups respectively. Participants in the intervention and control groups had a mean KOOS function in daily living of 61.11 (SD=21.20) and 56.72 (SD=22.13) respectively. Overall mean baseline of KOOS function in sport and recreation was 35.30 (SD=27.38).
    Conclusions: Majority of participants had moderate level of knee pain and functional disability in daily living. However, participants had more extreme symptoms of functional disability in sport and recreation. Therefore, interventions to reduce knee pain and functional disability symptoms in knee OA are needed.

    Study site: Orthopedics Clinics in Hospital Putrajaya and Hospital Serdang, Malaysia
  10. Jaffar A, Mohd-Sidik S, Foo CN, Admodisastro N, Abdul Salam SN, Ismail ND
    JMIR Hum Factors, 2022 Feb 03;9(1):e30989.
    PMID: 35113025 DOI: 10.2196/30989
    BACKGROUND: Mobile health apps, for example, the Tät, have been shown to be potentially effective in improving pelvic floor muscle training (PFMT) among women, but their effectiveness in pregnant women was limited. Adherence to daily PFMT will improve pelvic floor muscle strength leading to urinary incontinence (UI) improvement during the pregnancy.

    OBJECTIVE: This study aims to document the validation process in developing the Kegel Exercise Pregnancy Training app, which was designed to improve the PFMT adherence among pregnant women.

    METHODS: We utilized an intervention mapping approach incorporated within the mobile health development and evaluation framework. The framework involved the following steps: (1) conceptualization, (2) formative research, (3) pretesting, (4) pilot testing, (5) randomized controlled trial, and (6) qualitative research. The user-centered design-11 checklist was used to evaluate the user-centeredness properties of the app.

    RESULTS: A cross-sectional study was conducted to better understand PFMT and UI among 440 pregnant women. The study reported a UI prevalence of 40.9% (180/440), with less than half having good PFMT practice despite their good knowledge. Five focus group discussions were conducted to understand the app design preferred by pregnant women. They agreed a more straightforward design should be used for better app usability. From these findings, a prototype was designed and developed accordingly, and the process conformed to the user-centered design-11 (UCD-11) checklist. A PFMT app was developed based on the mHealth development and evaluation framework model, emphasizing higher user involvement in the application design and development. The application was expected to improve its usability, acceptability, and ease of use.

    CONCLUSIONS: The Kegel Exercise Pregnancy Training app was validated using a thorough design and development process to ensure its effectiveness in evaluating the usability of the final prototype in our future randomized control trial study.

  11. Gan QF, Lim YT, Foo CN, Yu CW, Woon CK, Cheong SK, et al.
    Curr Stem Cell Res Ther, 2023;18(2):202-215.
    PMID: 35392790 DOI: 10.2174/1574888X17666220407085901
    BACKGROUND: Cardiovascular disease (CVD) is one of the world's leading causes of increased morbidity and mortality. Current interventions for CVD, including percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG), carry certain risks and complications, which may also affect the patient's quality of life. It is important to minimize those risks and complications while speeding up the recovery. Insulin Growth Factor-1 (IGF-1) is a growth factor responsible for cellular migration, proliferation, differentiation, and angiogenesis, which supports cardiovascular regeneration.

    METHODS: In light of the current trend of regenerative medicine, the present review aims to pool data relating to the incorporation of IGF-1 in regenerative medicine and provide input on the current research gaps and concerns arising on translating this approach from benchwork into clinical settings.

    RESULTS: Using the keywords IGF-1 'OR' Insulin Growth Factor 1 'AND' Mesenchymal Stem Cells 'AND' Tissue Healing from 2009 to 2020, we identified 160 and 52 from Medline and PubMed, screening out 202 articles due to non-fulfilment of the inclusion criteria.

    CONCLUSION: Incorporating IGF-1 into regenerative and personalized medicine may be promising for treating CVD; however, the concerns include the role of IGF-1 in inducing cancer growth and its ability to migrate to the specific site of injury, especially for those who present with multiple pathologies should be addressed prior to its translation from bench work into clinical settings.

  12. Tan SY, Foo CN, Ng FL, Tan CH, Lim YM
    Gene, 2025 Jan 30;935:149043.
    PMID: 39486662 DOI: 10.1016/j.gene.2024.149043
    Breast cancer remains a significant global health concern, impacting millions of women every year. Maslinic acid (MA), a pentacyclic triterpene has been found to exert promising anticancer effect in various cancers, including breast cancer, yet the underlying mechanisms remain unclear. This study aims to elucidate the anticancer properties of MA via gene expression profiles in breast cancer cells. Cytotoxicity assay results revealed that MCF-7 exerts the highest sensitivity after 72 h of MA treatment followed by T-47D and MDA-MB-231. MCF-7 were then selected for in-depth analysis using the Nanostring nCounter Pancancer Pathway Panel to analyze the differential expression of genes (DEGs). Across three time points (24, 48, and 72 h), 20 significant DEGs were identified, of which 5 were upregulated and 15 were downregulated. In silico analysis indicated that these DEGs were involved in Pathway of Cancer, Focal Adhesion-PI3K-mTOR Signaling Pathway, PI3K-Akt, and Ras Signaling Pathway. The regulation of these DEGs contributes to several cellular activities such as apoptosis, inhibition of cell proliferation, cell cycle and survival, reduction of glycolysis, angiogenesis, and DNA repair. Additionally, the unfolded protein response emerged as a noteworthy biological process in this study. This study unravels the molecular mechanisms underpinning the therapeutic potential of MA against breast cancer.
  13. Jaffar A, Muhammad NA, Mohd Sidik S, Admodisastro N, Abdul Manaf R, Foo CN, et al.
    PMID: 35329262 DOI: 10.3390/ijerph19063574
    Pelvic floor muscle training (PFMT) is crucial to improving urinary incontinence (UI). This study aimed to assess the Kegel Exercise Pregnancy Training (KEPT) app’s feasibility and usability. This is a subgroup analysis from a researcher-blinded, randomised controlled pilot feasibility study among pregnant women with UI. The Malay version of the mHealth App Usability Questionnaire (Interactive) evaluated the app’s usability. Ten pregnant women completed the study, with mean age (SD) of 28.9 years (3.1). The app’s feasibility was rated above average. The app was reported with usable in all domains, (1) system information arrangement (4.98/7.0), (2) usefulness (4.89/7.0) and (3) ease-of-use and satisfaction (5.03/7.0). Education level was negatively correlated with the app’s feasibility (r = −0.81, p < 0.001) and all domains of usability such as ease-of-use (r = −0.66, p = 0.01), system information (r = −0.81, p = 0.001) and usefulness (r = −0.81, p = 0.001). PFMT video was among the app features chosen to be helpful. This study demonstrates that the newly developed user-centred design KEPT app is feasible and usable. However, the future app should provide direct feedback about their exercise techniques to motivate PFMT adherence.
  14. Yap SY, Foo CN, Lim YM, Ng FL, Mohd-Sidik S, Tang PY, et al.
    Int J Environ Res Public Health, 2021 May 18;18(10).
    PMID: 34069915 DOI: 10.3390/ijerph18105366
    Depression is commonly observed in university students, who are a high risk group for developing psychiatric disorders during adulthood. This study aimed to determine the prevalence of depression and its traditional Chinese medicine body constitutions and psychological determinants among university students in Malaysia. A cross-sectional pilot study was conducted between 9 and 28 September 2020 among 80 university students in Malaysia. Participants completed online survey questionnaires, including the validated Patient Health Questionnaire (PHQ-9), Constitution in Chinese Medicine Questionnaire (CMCQ), Dysfunctional Attitude Scale (DAS), Depression Anxiety Stress Scale (DASS-21) stress subscale, Perceived Stress Scale (PSS-10), and Rosenberg Self-Esteem Scale (RSES), which assess depression, body constitution, dysfunctional attitude, stress, perceived stress, and self-esteem. Multiple linear regression analyses were performed to determine the associated risk factors for depression. The overall prevalence of depression among university students was 33.8%. The multiple regression analysis showed a significant relationship between depression and qi-stagnation constitution (B = 0.089, p = 0.011), balanced constitution (B = -0.077, p = 0.049), and self-esteem (B = -0.325, p = 0.001). Our findings suggest that some traditional Chinese medicine body constitutions and self-esteem are significant risk factors affecting depression among university students. Identifying risk factors of depression is vital to aid in the early detection of depression among university students.
  15. Sidik SM, Jaffar A, Foo CN, Muhammad NA, Abdul Manaf R, Ismail SIF, et al.
    BMJ Open, 2021 01 12;11(1):e039076.
    PMID: 33436465 DOI: 10.1136/bmjopen-2020-039076
    INTRODUCTION: Pelvic floor muscle training (PFMT) strongly recommended to incontinent pregnant women. The Kegel Exercise Pregnancy Training-app trial is a multicentre cluster-randomised study aims to assess the effectiveness and its cost-effectiveness of the mobile app guidance in PFMT among incontinent pregnant women.

    METHODS AND ANALYSIS: 370 pregnant women (aged 18 years old and above) will be recruited with International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form. Ten clusters (primary care clinics) will be randomly assigned to either PFMT or usual care in a 1:1 ratio by an independent researcher (sealed envelope). The primary outcome will be urinary incontinence, and the secondary outcomes (quality of life; PFMT adherence, psychological status and mobile apps' usability) will be assessed at four measurement time points (t0: baseline) and postintervention (t1: 4 weeks, t2: 8 weeks and t3: 8 weeks postnatal). T-test analysis will determine any significant differences at the baseline between the control and intervention groups. The mixed-model analysis will determine the effectiveness of the intervention at the population-average level for both the primary and secondary outcomes. For the cost-effectiveness analysis, expenditures during the study and 6 months after the intervention will be compared between the groups using the multiway sensitivity analysis. The recruitment planned will be in December 2020, and the planned end of the study will be in August 2021.

    ETHICS AND DISSEMINATION: This study protocol was approved by the Ethics Committee for Research Involving Human Subjects, Universiti Putra Malaysia (JKEUPM-2019-368) and Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia, NMRR-19-412-47116 (IIR) with the ANZCTR registration. This study will obtain informed written consent from all the study participants. The results which conform with the Consolidated Standards of Reporting Trials and the Recommendations for Interventional Trials will be published for dissemination in peer-reviewed journals and conference proceedings.

    TRIAL REGISTRATION NUMBER: ACTRN12619000379112.

  16. Wong CY, Tham JS, Foo CN, Ng FL, Shahar S, Zahary MN, et al.
    Biosaf Health, 2023 Feb;5(1):37-44.
    PMID: 36588928 DOI: 10.1016/j.bsheal.2022.12.005
    Vaccination is crucial in controlling the spread of the coronavirus disease 2019 (COVID-19) that triggered the pandemic, but herd immunity can only work with high vaccination coverage in the population. This study aims to measure the COVID-19 knowledge level and determine the factors influencing COVID-19 vaccination intention among university students in Malaysia. A cross-sectional online survey was carried out with 1,274 Malaysian university students in July 2021. Univariate and multivariate analyses were employed to examine the relationships between the study variables. Results showed that the majority of university students had an acceptable level of knowledge of COVID-19. The knowledge, risk perception of COVID-19, social norms, and perceived benefit of COVID-19 vaccination were positively associated with vaccination intention. However, perceived trust in information sources of COVID-19 vaccination and the government's response to COVID-19 did not affect the university students' desire to receive the vaccination. These findings are essential for health policymakers and healthcare providers to implement evidence-based interventions to increase COVID-19 vaccination uptake among university students.
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