AT Healthcare Research Project - Help!

[HillMedic]

Hi. I am a long time casual reader of this forum, never a poster. I love the AT and do some section hikes as time allows. My hometown is Kingsport, TN, just north of Erwin.

I am a Doctor of Nursing Practice Student. Hopefully this forum can help me with my doctoral project. I am strongly considering investigating access to healthcare of AT thru hikers/long distance hikers. Other than some conversation with friends, this is the first time I have attempted to gain information straight from hikers.

At this point, I just want to see if there is a problem that I can investigate. It seems that nothing like this has been done before. Can you help me get a general idea of the need for healthcare on the trail? How many thru hikers have to come off trail for formal care? How many need formal care but don't get it because of difficulty of access? How many drop out because of injury or illness? Is this even a legit project for me? Would I have a solid number of thru hikers who would agree to let me track their progress?

Please help me get started so I can spend time with the 2015 class instead of switching topics and crunching numbers in an office somewhere! Thanks a ton.

[swonut]

It's a very interesting topic. I think hard data will be difficult to come by. Doesn't make it impossible, but makes it difficult. To me, the big medical problems are one's feet and knees in the beginning, the rotovirus outbreak of 13, Lyme disease, and weight loss toward the end. I suggest trying to limit your data set by picking a subset of hikers. If it were me, I'd maybe try to get 100 or so hikers that stayed at Hiker Hostel in March and then follow them through the hikes. (Not sure of finances, but maybe taking a week and staying at the hostel to interview the hikers and establish a connection so they would be more likely to respond and report. Most everyone has email and many blog their journeys. It'd be a lot of clicking to try to keep up, but it would be interesting to watch. I thought about a book that started with Breakfast on a March morning and tracked the hikers from there.

Also could maybe pick a hostel or resupply point near you and have a questionnaire that you administered as the bubble came through. Would be interesting to see who had insurance and who did not. Maybe also interview the emergency rooms in trail towns to see what conclusions you could draw.

[Lynnette]

First, good luck with what ever PhD research you decide on. If you do go with AT or long distance hikers - capture age, country/state of origin and if one of those push-activate rescue badges are used. I hiked, was wounded and had broken bones several times: saw ERs, Drs, WEMTs, Vit I from other hikers. Only once was I so smelly and dirty and in so much pain which could not be relieved by 7 different drug shots that I was dismissed as a druggie even tho I had an insurance card. Firing nerve pain does not get relief from most medications. Another time the insurance dismissed the injury as non medical - bit down on a slightly frozen power bar in NH and dislocated and cracked the TM joint and mouth was in pain wouldnt open. They said use a straw. Would this instruction have been given to a non hiker? Baby boomers are now more prevalent on the trails and have osteo everything and bust knees. I have done thesis level research on other subjects and consider that while statistical data can be gathered about hiker illness/injury and access to care, at first glance it seems there is little on PhD level to analyze and conclude. But if you do this be sure to share your statistics with all. It would be great to know all the places we should go to or not go if sick or wounded. Good luck.

[freightliner]

I'm hoping to thru hike the trail next year and I'd be happy to volunteer. I will be hiking out after the kick off this march. Just pm me if interested.

[WingedMonkey]

How many thru hikers have to come off trail for formal care? How many need formal care but don't get it because of difficulty of access? How many drop out because of injury or illness?

I never left the trail on my thru-hike to seek medical attention. Had some injuries but didn't quit.

Then again I haven't sought medical attention for about 25 years now.

[OCDave]

HillMedic, i

It seems you should have plenty of possibilities developing an interesting DNP project.

There are frequently posts here inquiring about hiking with "insert chronic medical condition here". You might consider limiting the scope of your project to hikers with certain chronic conditions. Survey hikers with condition "x" regarding their "prior to hike" health plan, then if you can follow-up in anyway, how well that plan worked. Or, is there an intervention that increases the likelihood of of completeing a thru-hike with condition X? Can an interventiuon prolong the number of days a hiker with condition X remains on the trail? Does the number of chronic medications predict how far and individual will progress before withdrawing?

Alternatively, lifestyle change as the intervention; Monitor BP, Lipids, A1C, BMI ect of a selected group of hikers at regular intervals as they hike. A large enough group would allow you to generate a paper regarding the health benefit of an extended hike vs detriment of limited diet, excess wear and tear, ect.

I would guess that it would be difficult to gather anything meaningful regarding ACUTE injury or illness along a 2000 trail.


Good Luck, I look forward learning what you find.

[hikehunter]

Maybe, ad to your study..."how many hikers are first aid trained" "most used or carried first aid items" "prescription medication availability"
"classify the medical stations and their abilities along the trail"....send out a servay to the small town med.clinics and hospitals...
You have many directions to go here....see if NOLS has information or is willing to support your work.

[HillMedic]

All great info! Keep it coming!

[Don H]

Roland Muser wrote a book based on surveys he did with AT thru-hikers in '98. Some of the information he touched on was medical related, you might want to review his work. Roland sent surveys to hikers and did follow up with them. He found, and I think you will too, that hikers are very willing to participate in your study.

I'd like to see studies on malnutritian and Lyme disease in thru-hikers.

[Don H]

Here's a link to Roland Mueser's book http://www.amazon.com/Roland-Mueser/e/B001IODF8Q

It would be interesting to see his survey done today, 25 years later.

[ericmack]

Hi. I am a long time casual reader of this forum, never a poster. I love the AT and do some section hikes as time allows. My hometown is Kingsport, TN, just north of Erwin.

I am a Doctor of Nursing Practice Student. Hopefully this forum can help me with my doctoral project. I am strongly considering investigating access to healthcare of AT thru hikers/long distance hikers. Other than some conversation with friends, this is the first time I have attempted to gain information straight from hikers.

At this point, I just want to see if there is a problem that I can investigate. It seems that nothing like this has been done before. Can you help me get a general idea of the need for healthcare on the trail? How many thru hikers have to come off trail for formal care? How many need formal care but don't get it because of difficulty of access? How many drop out because of injury or illness? Is this even a legit project for me? Would I have a solid number of thru hikers who would agree to let me track their progress?

Please help me get started so I can spend time with the 2015 class instead of switching topics and crunching numbers in an office somewhere! Thanks a ton.

About finished with dissertation in Poly Sci that uses a lot of statistical analysis. You will need to randomize your sample as much as possible and I would consider being at northern terminus to conduct systemic interviews of those who made it- however you define the parameters of your sample (section? one shot thru?). Another piece of data is the access explanation of the trail (for any given mile- how accessible is medical treatment. Finally- you look at self-care, hiker care (help from another hiker), and professional medical care.

Sounds like a good project.

Eric (tinman)

[jred321]

I'm wondering if one year will be enough data to provide a meaningful sample. I would imagine year to year the needs are going to vary so for an overall picture it might take a few years. I guess that probably depends on the specific topic being investigated and not just healthcare on the trail in general. Something to think about - would your project be able to depict healthcare on the AT or would it only be able to depict healthcare on the AT in 2015