Concurrent Approach Research Articles

Understanding the Travel Decision-Making Behaviors of Ethnic Minority Tourists: The Moderating Role of Psychological Empowerment

Grounded on the concept of ethnicity, this paper explores the travel consumption and decision-making behaviors of ethnic minority travelers through the lens of psychological empowerment. Employing a quantitative-dominant concurrent nested mixed-methods approach, 951 surveys (404 white and 547 ethnic minority participants), 6 focus groups, and 10 semi-structured interviews (with ethnic minority travelers) were conducted in the UK. The findings reveal the existence of prejudices and discrimination experienced by ethnic minorities during international and domestic travel, with ethnicity being a key factor. The paper identifies the need to adopt a multi-level empowerment approach, where psychological empowerment is found to be key to understanding how negative experiences and perceived risks are accepted, feared, and/or transformed into sources of interactional and intrapersonal empowerment. This has significant positive impacts on international and domestic travel intentions of ethnic minorities. The theoretical, methodological, and management implications of the study are discussed.

Sustainable tourism development through community homestays: a case study of Ayodhyapuri Community Homestay in Madi, Chitwan, Nepal

ABSTRACT In rural areas of Nepal, homestays are becoming an important source of income for many families. Homestay offers many benefits, such as experiencing the local culture, learning about different cultural practices in a homely environment, improving language skills, and many more. This study is an attempt to explore the status and homestay owners’ perceptions of Ayodhyapuri Community Homestay, Madi, Nepal. In this study, a concurrent mixed-methods approach was applied using a questionnaire and informal interviews to understand the homestay situation. The research explores how a specific community in Nepal has developed a sustainable tourism industry through the use of homestays, with a focus on how the community has balanced economic growth with environmental and cultural sustainability. Along with this, it also examines the impact of ecotourism on the local community, including the economic benefits, social and cultural impacts, and environmental sustainability practices. The finding suggests that homestays play a vital role in conserving nature, reducing human-wildlife conflict, preserving culture, and generating employment opportunities.

An Evaluation of the Implementation of the Social Studies Curriculum in Ghana: A Case Study of the Asante Akim North District

The purpose of this study was to evaluate the Social Studies Curriculum for Senior High Schools in Ghana to determine whether the subject has attained its goal(s). The study took place in the Asante Akim North District. The population for study were all Social Studies teachers and students in the district. The multi-stage sampling technique was adopted for the study and the sample size was 120, made up of 100 students and 20 teachers. The concurrent mixed method approach was adopted. The main instruments used for collecting data were questionnaires, interviews (focus group and semi-structured interview) guide, observation and documentary analysis. Quantitative data were tabulated, organized, analysed and interpreted to draw sound conclusions and generalizations. The data were presented in the form of tables and percentages. Words were used to interpret the tables and percentages for easy understanding. The qualitative data responses were described and explained in the form of themes. Sometimes responses were quoted verbatim to authenticate claims made. The study revealed that most of the teachers who are the curriculum implementers have forgotten the subject's general objectives. Therefore, they teach the subject without any cognizance of the attainment of these objectives. Concerning the findings of the study, it is recommended that the district education directorate should organize periodic workshops, in-service training and seminars for teachers teaching the subject. This will help Social Studies teachers acquire the relevant knowledge and the pre-requisite skills needed to effectively implement the Social Studies curriculum in the Asante Akim North District.”

A concurrent mixed-method study exploring the experiences of interprofessional collaboration among Canadian midwives and obstetricians.

This study explores the experiences of interprofessional collaboration of Canadian midwives and obstetricians from midwives' perspective. A concurrent mixed-methods approach that combined a small validation study and qualitative thematic analysis was used to provide evidence of the nature and importance of collaboration between Registered Midwives (RMs) and obstetricians. Eighteen RMs across Canada completed a demographic survey and the Midwifery-Obstetrician Collaboration (MOC) scale in 2023. The quantitative analyses were conducted to assess the reliability of the Midwifery-Obstetrician Collaboration (MOC) and accumulate preliminary evidence to support its validity. Semi-structured interviews were conducted with 13 participants. After completing the interviews, themes were identified using thematic analysis. The primary themes identified were knowledge of midwifery scope affects collaboration, collaboration is necessary for effective patient care, midwife-physician collaboration is impacted by power differentials and hierarchies, and proposed methods to improve physician-midwife collaboration. Although a small sample size did not permit extensive statistical testing, the quantitative results supported the reliability of the MOC scale. In addition, a strong correlation between the MOC and the communication subscale of the Inter-Professional Collaboration (IPC) scale provided evidence of the MOC's concurrent validity as a measure of collaboration between midwives and physicians. This study provides support for the Midwifery-Obstetrics Collaboration (MOC) Scale as an assessment tool to evaluate collaboration between midwives and OB/GYNs in obstetrics care. While the 18 RMs recruited for this study provided a fulsome analysis for the qualitative portion, a larger study is necessary to provide more extensive quantitative analysis to validate the MOC scale for continued use among RMs and OBs. The implications of this study are to foster strong interprofessional relationships between midwives and OBs and to improve the health outcomes of pregnant women and newborns. The authors adhered to Consolidated criteria for reporting qualitative research (COREQ).

Life course studies – conceptual and methodological approaches and solution

Studies of the life course address the fundamental issue of social sciences – understanding the social change, its directions, reasons and perspectives, the interaction of micro- and macro levels of social reality. Studies of life course developed independently in different social sciences and scientific traditions cover a broad range of topics, issues and methodological approaches. These variety of studies were grouped into few major research frameworks: psychological within the studies of personality development; longitudinal sociological focused on life course of different cohorts and comparative studies of generations, social groups, countries and regions; domain-based – studies of trajectories in different life domains; demographic studying the timing of life events; studies of stability and transformation of values and biographical research. The multiple methodological approaches to study the life course are suggested to group in two main categories – concurrent and retrospective which differ by the time distance between the occurrence of an event and the reporting about the event. Concurrent approach is characterized by relatively high reliability of the measurement, but low flexibility in selecting research indicators, long time for the organization of data collection and large financial investments. Retrospective approach provides high flexibility in organization and design of the survey, allows free selection of indicators to test research hypotheses, but the reliability of the data is hampered by the memory errors and context effect. None of these approaches alone can satisfy the needs and requirements of studying the life course and collecting dynamic multi-level data. The possible solution is to design and test the multimodal approach combining the advantages of different research methods and mitigating their drawbacks. The new long-term longitudinal project “Life course, values and expectations of the generation of 1990s” (G90) included the test of an autobiographical method of data collection for random samples of the general population in quantitative design. The testing revealed high sensitivity of the method to the format (handwritten, printed or oral), high differentiation between respondents in completeness of information and the selection of events included in the autobiography. Supplementing autobiographies by in-depth interviews increased the data standardization, completeness and comparability. The drawbacks of this method found during the survey are high demand for resources for data analysis, individual approach to each autobiography, low respondents’ cooperation in highly demanding tasks, and ethical issues. The future of the life course studies can be found in the convergence of different research frameworks, multidisciplinary research projects, and the application of mixed-model integrated methodology.

PERUMUSAN STRATEGI PEMASARAN BERKELANJUTAN THE BLOOMS GARDEN UNTUK MENDUKUNG KOLABORASI DESTINASI PARIWISATA


 
 
 This research was carried out at the tourist destination The Blooms Garden Bedugul Bali. This study aims to analyze (1) the current marketing strategy of The Blooms Garden Bedugul Bali; and (2) formulation of a sustainable marketing strategy for The Blooms Garden to support collaborative tourism destinations in Bedugul. This research is categorized as research with a Concurrent Mixed Method approach. The data collected is in the form of qualitative data and quantitative data. Qualitative data were collected from interviews, observations and documentation. Meanwhile, quantitative data was collected by gathering information from The Blooms Garden management regarding strengths, weaknesses, opportunities and threats which were then converted into numerical data with weights and ratings. Analysis of data sourced from interviews, observation and documentation was analyzed using interactive data analysis techniques from Miles & Huberman. Determination of the marketing strategy implemented by the manager of the tourist attraction of The Blooms Garden is analyzed using SWOT analysis.
 The results of the study show that (1) the current marketing strategy undertaken by The Blooms Garden Bedugul Bali to attract and increase tourist visits includes the installation of banners and billboards scattered along the road from Denpasar to Bedugul; website opening; via social media; and cooperate with online travel agencies such as traveloka, tiket.com, and so on. However, the marketing strategy undertaken by The Blooms Garden has not succeeded in bringing in tourists as expected; and (2) The Blooms Garden's sustainable marketing strategy formulation to support collaborative tourism destinations in the Bedugul region is an integrated diversification strategy. This marketing strategy means that The Blooms Garden Bedugul Bali can integrate with other tourism destinations in the Bedugul area. The sustainable marketing strategy in collaboration with other destinations in the Bedugul area is intended as an effort to increase tourist visits, especially environmentally conscious tourists who often visit the well-known Botanical Gardens and Lake Beratan, directed to visit The Blooms Garden as well. If possible, pass tickets apply between the Botanical Gardens, Lake Beratan and The Blooms Garden.
 
 

Facilitators and barriers for implementation of health programmes with Māori communities.

Addressing health inequities that Māori (Indigenous peoples) communities face in New Zealand is a key aim of researchers and practitioners. However, there is limited understanding of the implementation processes and outcomes of health programmes for addressing these inequities. The aim of this study was twofold: (a) to identify correlates of implementation outcomes and (b) to identify facilitators and barriers to implementation effectiveness. The study involved a concurrent mixed method approach. Through an online survey, 79 participants with experience in implementing a health programme with a Māori community identified outcomes and processes of the programme. Additionally, nine Māori community providers shared their perceptions and experience of facilitators and barriers to implementation effectiveness through an in-depth interview. The quantitative and qualitative findings were integrated to address the aims of the study. For the first aim, we identified two key outcomes: overall health impacts and sustainability. Three of the variables had significant and positive bivariate correlations with health impacts: cultural alignment, community engagement, and individual skills. The only significant correlate of sustainability was evidence-based. For the second aim, participants described four facilitators (leadership, whanaungatanga [relationships], sharing information, digestible information) and four barriers (system constraints, lack of funding, cultural constraints, lack of engagement) to effective implementation. Overall, leadership, aligning culture, and building on whanaungatanga, while getting financial resources and systems support, are the core elements to supporting implementation efforts in Māori communities.

Correlates of Commitment to Career Choices of Pre-Service Education Students in Selected Universities in Kenya

The study attempted to establish the correlates of commitment to career choice of pre-service education students in six public and private universities in Kenya. The third and fourth year pre-service education students were the respondents in this study. Correlational research design and concurrent mixed method approach was employed in this study. Purposive, cluster and convenience sampling methods were used. Data were gathered by the use of questionnaires and interviews. In data analysis, frequencies, means, standard deviation, linear regression and Pearson product moment correlation coefficient were used. The pre-service education students were found to be moderately committed to their career choice and that intrinsic motivation, self-concept, status of the teaching profession, fallback and socio-cultural beliefs were correlated to career choice. Fallback however had an inverse correlation to the commitment of career choice. The study recommends that factors which motivate pre-service education student’s choice of teaching as a career should be clearly understood, so that only students motivated by those factors which were found to promote commitment, like intrinsic motivation, self-concept, status of the teaching profession and social cultural beliefs are the ones placed to train as teachers.

Patterns of inter-state irregular migration in Africa: insights from Ethiopian migrants to the Republic of South Africa

Recent research suggests a significant rise in both international and intra-African migrations, with South Africa emerging as the primary destination for irregular migrants in the region. However, the phenomenon of irregular migration to South Africa has received limited attention despite the growing number of migrants hosted by the country. To address this gap, this study adopts a concurrent cross-sectional mixed-methods approach to explore the patterns of inter-state irregular migration in Africa, specifically focusing on Ethiopian migrants to the Republic of South Africa (RSA). The investigation draws on quantitative data collected from 316 migrant returnees, as well as qualitative in-depth interviews and focus-group discussions. The findings of this study reveal that there is a decline in the patterns of Ethiopian irregular migration to the RSA within the past decade due to tight legal restrictions. The COVID-19 pandemic has had a significant impact on the pattern of irregular migration, leading to a decline in the number of migrants from mid-2018 to 2020 due to stringent border closures. Irregular migration to the RSA tends to be temporary, with an increasing migrants returning to their home country once they have achieved economic success or as they encountered precarious conditions at the destination. Addressing the root causes that drive migration, improving border control mechanisms, and implementing inclusive integration strategies are key steps toward minimizing the risks and maximizing the benefits associated with this migration phenomenon.

Exploring therapeutic communication in managing chronic non-communicable diseases: a mixed-method study in Ghana

BackgroundGlobally, the burden of chronic non-communicable diseases is increasing rapidly and approximately one in three of all adults suffer from multiple chronic conditions. Therapeutic communication plays a crucial role in achieving curative, preventive, and promotive goals regarding chronic disease management. We examined therapeutic communication between health professionals and patients with chronic non-communicable diseases at the Ho Teaching Hospital.MethodsWe adopted a concurrent mixed-methods approach. The quantitative aspect of the study was descriptive while the qualitative was explanatory. The quantitative study was conducted among 250 patients. The qualitative data was collected among eight health professionals. A stratified sampling and simple random sampling methods were used to recruit patients for the quantitative survey while purposive and convenient sampling was used for the qualitative aspect of the study. The quantitative data was collected using a semi-structured questionnaire while the qualitative data was collected using an in-depth interview guide. The quantitative data were analyzed using STATA v17 and the qualitative data were analyzed thematically using Atlas ti. The major themes that emerged were, therapeutic communication practices, barriers to therapeutic communication and possible solutions to good therapeutic communication.ResultsWe found that 37% patients were 60 years and above with 53.2% being females. It was noted that 36.4% of patients have had tertiary-level education. We found that 59.2% of patients reported having good therapeutic communication with health professionals. We, however, noted that male participants were 92% less likely to practice good therapeutic communication compared with females (aOR = 0.92,95% Cl = 0.46–1.84). Health professionals’ activities to ensure good therapeutic practices included their capacity to listen, build rapport with their patients, and clarify information. We found that the major facilitators of good therapeutic communication included trust in the health professionals (90.4%), conducive environment (93.2%), using simple and plain language by health professionals (92.0%) We found that there are myriad of barriers that impede communication process. This included language, health professionals’ inability to break terminologies, and the unconscious state of patients.ConclusionsThe study revealed that there was good therapeutic communication between health professionals and patients with CNCDs. Nevertheless, it was also identified that ineffective therapeutic communication between health professionals and their patients due to barriers like language could lead to dissatisfaction with care, misdiagnosis, and noncompliance to treatment regimen. For Ghana as a country to achieve SDG target 3.4 by reducing mortality due to NCDs and improve wellbeing of patients by 2030, it will be imperative on Ghana Health Service to design communication strategy training for health professionals that could help improve therapeutic communication between patients and health professionals.

Not a passive learner but an active one: a focus on the efficacy of philosophy-based language instruction and its consequences on EFL learners’ critical thinking, engagement, and academic achievement

This study investigates the impact of Philosophy-Based Language Teaching (PBLT) on the critical thinking skills and learner engagement of English as a Foreign Language (EFL) students. A concurrent mixed-methods approach, including semi-structured interviews, document analysis, and academic achievement tests, was employed with an experimental group (EG) exposed to PBLT and a control group (CG) receiving traditional instruction. The results reveal a substantial positive effect of PBLT on the critical thinking abilities of EFL learners, as evidenced by thematic analyses of interviews and document content. Themes include heightened critical thinking awareness, collaborative knowledge construction, and increased learner engagement. Academic achievement tests further demonstrate significant improvement in the experimental group’s performance. A comparison with existing literature underscores the novelty of our mixed-methods approach. Implications for language teachers, materials developers, syllabus designers, and policy-makers are discussed, highlighting the potential of PBLT in cultivating critical thinking and learner engagement.

Bold techno competence in language learning: a study on the effects of efficacy of workshops in decreasing technostress and boosting academic enjoyment, autonomy, and language achievement

This study investigated the impact of techno-competence workshops on English as a Foreign Language (EFL) learners’ language achievement, technostress, academic enjoyment, and autonomy in a large university in Iran. A concurrent mixed-methods approach was employed, with qualitative data collected through structured interviews and quantitative data gathered using a teacher-made test validated through a known-group procedure. Ninety-six upper-intermediate EFL learners were randomly assigned to an Experimental Group (EG) and a Control Group (CG). Results revealed a significant decrease in technostress, an increase in academic enjoyment, and heightened autonomy among participants attending the techno-competence workshops. The quantitative analysis demonstrated a substantial improvement in language achievement for the EG compared to the CG. Findings contribute to the understanding of the multifaceted impacts of techno-competence on language learning outcomes and offer practical insights for educators, curriculum developers, and policymakers in fostering effective language education in technologically enriched environments. Despite certain limitations, this study lays the groundwork for future research endeavors exploring the intricate dynamics between techno-competence and language learning outcomes across diverse contexts.

Establishing Factors Leading to the Pre-service Education Students’ Choice of Teaching as a Career

This paper established factors leading to the pre-service education student’s choice of teaching as a career. The third and fourth year pre-service education students from six public and private universities in Kenya were the respondents. Concurrent mixed method approach was employed in this study. Purposive, cluster and convenience sampling methods were used. Data were gathered using questionnaires and interviews. In data analysis, frequencies, means and standard deviation were used. The study established that the following factors affected pre-service education student’s decision to become teachers. (i) Fallback, (ii) External factors, (iii) Self-concept (iv) Altruistic reasons (v) Extrinsic reasons and (vi) Intrinsic motivation. The findings established that all the influential factors were important to the pre-service education students to join the teaching profession. None of the influential factors was very important to their decision to choose teaching as a career. The pre-service education students pointed out that their high school grade is what really determines their career path. Fallback as one of the influential factors was found to have been slightly important in their decision to enter the teaching profession.

Roles of health system leadership under emergency in drought-affected districts in northeast Uganda: a mixed-method study

ObjectiveHealth system leadership plays a critical role in sustaining healthcare delivery during emergencies. Thus, we aimed to assess the contribution of health system leadership in sustaining healthcare delivery under emergency...

Catalyzing the growth of green bonds: a closer look at the drivers and barriers of the Canadian green bond market

PurposeThis paper aims to examine the Canadian financial sector’s reaction to opportunities and risks created by the green bond market in a low-carbon and climate-resilient (LCR) economy.Design/methodology/approachThe authors used a concurrent mixed methodological approach that undertakes an online survey and semistructured interviews with critical green bond market stakeholders.FindingsThe most significant market driver in Canada is the reputational benefit for stakeholders, i.e. its ability to meet the high demand for sustainable finance and the marketing potential of its green credentials. The major market barriers are transactional costs, i.e. additional tracking required for reporting purposes, lack of market liquidity and identification of environmental impact or additionality. Canadian green bonds are also more likely to be evaluated on their green impact than their global market peers.Research limitations/implicationsLimitations of this study include its focus on Canada, which may exclude or not apply to drivers and barriers in other green bond markets.Practical implicationsThe paper helps create an accounting-based conceptual framework for key motivations and barriers that affect financial decision-making regarding green bonds.Social implicationsThe authors identify economic and policy-related barriers and drivers for green bonds, addressing the financing gap for the LCR economy.Originality/valueTo the best of the authors’ knowledge, this study is the first to identify and compare Canadian green bond market drivers and barriers and to examine relevant stakeholder- and policy-related approaches that can be targeted to scale this market effectively.

Role reversal in adult child-aging parent family travel

While family tourism has gained increasing attention from researchers, the relationship between adult children and their parents in family vacations remains an under-researched area. Drawing on role reversal theory and social exchange theory, this research examines the effects of role reversal on the well-being of adult children in family travels and with respect to “individual” and “relation” perspectives as mediating mechanisms. A quantitative-dominant concurrent nested mixed methods approach was employed. Results show that adult children can benefit from assuming the parental role in relation to their elderly parents as this reversal in roles can promote their well-being by stimulating their commitment to parents and by reducing their perceived cost of sacrifice. These effects were also moderated by their parents' confirmation.

Pre-service Education Students’ Commitment Level to Their Career Choice

The study attempted to establish commitment level to career choice of pre-service education students in six public and private universities in Kenya. The third and fourth year pre-service education students were the respondents. Correlational research design and concurrent mixed method approach was employed in this study. Purposive, cluster and convenience sampling methods were used. Data were gathered by the use of questionnaires and interviews. In data analysis, frequencies, means, standard deviation, linear regression and Pearson product moment correlation coefficient were used. The pre-service education students were found to be moderately committed to their career choice. The study recommends Improvement of career guidance in schools so that students clearly understand and choose careers in relation to their interest and abilities because this will increase their commitment to their career choices and reduce the job hopping being experienced in the world of work.

Treatment of patients with anorexia nervosa and comorbid post-traumatic stress disorder; where do we stand? A systematic scoping review.

Comorbid post-traumatic stress disorder in patients with anorexia nervosa may negatively affect the course of anorexia nervosa treatment, which is already challenging. There are currently no guidelines or recommendations on concurrent treatment approaches for both anorexia nervosa and post-traumatic stress disorder. This systematic scoping review aims to explore the feasibility, acceptability and effectiveness of psychological trauma-focused treatment concurrently offered to underweight patients receiving anorexia nervosa treatment. A multi-step literature search, according to an a priori protocol was performed. Databases PubMed, Embase, APA PsycINFO, Web of Science, Scopus and Cochrane Central were searched up to September 19th 2022, and the search was rerun June 19th 2023. For quality assessment, Risk of Bias in Non-randomised Studies-of Interventions tool was used. The extensive search yielded 1769 reports, out of which only three observational pilot studies, both English and German, published between 2004 and 2022, could be included. The included studies reported on a total of 13 female participants between 16 and 58 years old, with anorexia nervosa or otherwise specified feeding or eating disorder, baseline BMI ranging between 14.6 and 16.5, who received concurrent anorexia and post-traumatic stress disorder treatment. In all participants, the emotional and cognitive functioning was sufficient to process the offered trauma-focused interventions, despite their significantly low body weight. The findings of this review identify a dearth of treatment research on knowledge of concurrent trauma-focused treatments for patients with anorexia nervosa. Refraining patients with anorexia nervosa from trauma-focused treatment may not be warranted.

Concurrent Learning Approach for Estimation of Pelvic Tilt from Anterior-Posterior Radiograph.

Accurate and reliable estimation of the pelvic tilt is one of the essential pre-planning factors for total hip arthroplasty to prevent common post-operative complications such as implant impingement and dislocation. Inspired by the latest advances in deep learning-based systems, our focus in this paper has been to present an innovative and accurate method for estimating the functional pelvic tilt (PT) from a standing anterior-posterior (AP) radiography image. We introduce an encoder-decoder-style network based on a concurrent learning approach called VGG-UNET (VGG embedded in U-NET), where a deep fully convolutional network known as VGG is embedded at the encoder part of an image segmentation network, i.e., U-NET. In the bottleneck of the VGG-UNET, in addition to the decoder path, we use another path utilizing light-weight convolutional and fully connected layers to combine all extracted feature maps from the final convolution layer of VGG and thus regress PT. In the test phase, we exclude the decoder path and consider only a single target task i.e., PT estimation. The absolute errors obtained using VGG-UNET, VGG, and Mask R-CNN are 3.04 ± 2.49, 3.92 ± 2.92, and 4.97 ± 3.87, respectively. It is observed that the VGG-UNET leads to a more accurate prediction with a lower standard deviation (STD). Our experimental results demonstrate that the proposed multi-task network leads to a significantly improved performance compared to the best-reported results based on cascaded networks.

Impact of point-of-care ultrasound use on patient referral decisions in rural Kenya: a mixed methods study

BackgroundPoint-of-care ultrasound (POCUS) is recognized as a key imaging modality to bridge the diagnostic imaging gap in Low- and Middle-Income Countries (LMICs). POCUS use has been shown to impact patient management decisions including referral for specialist care. This study explored the impact of POCUS use on referral decisions among trained healthcare providers working in primary rural and peri-urban health facilities in Kenya.MethodsA concurrent mixed methods approach was used, including a locally developed survey (N = 38) and semi-structured interviews of POCUS trained healthcare providers (N = 12). Data from the survey was descriptively analyzed and interviews were evaluated through the framework matrix method.ResultsSurvey results of in-facility access to Xray, Ultrasonography, CT scan and MRI were 49%, 33%, 3% and 0% respectively. Only 54% of the facilities where trainees worked had the capacity to perform cesarean sections, and 38% could perform general surgery. Through a combined inductive and deductive evaluation of interview data, we found that the emerging themes could be organized through the framework of the six domains of healthcare quality as described by the Institute of Medicine: Providers reported that POCUS use allowed them to make referral decisions which were timely, safe, effective, efficient, equitable and patient-centered. Challenges included machine breakdown, poor image quality, practice isolation, lack of institutional support and insufficient feedback on the condition of patients after referral.ConclusionThis study highlighted that in the setting of limited imaging and surgical capacity, POCUS use by trained providers in Kenyan primary health facilities has the potential to improve the patient referral process and to promote key dimensions of healthcare quality. Therefore, there is a need to expand POCUS training programs and to develop context specific POCUS referral algorithms.