| Purpose: The purpose of this study was to explore the experiences of RV-dwelling full-time American nomads when seeking healthcare in the U.S. and to identify barriers and facilitators of access to care.
Background: Up to a million or more Americans, live while traveling full-time in recreational vehicles (RVs). Some health policies are based on assumptions of stationary residency. Little attention in the literature has been devoted to the healthcare experiences of Americans who are geographically mobile.
Methods: The exploratory, qualitative design was informed by interpretive description. Levesque’s Conceptual Model of Access to Healthcare was used to generate questions for the interview guide. The principal investigator lived in an RV and traveled to a variety of campgrounds in several states to post recruitment flyers. Interviews were recorded and transcribed verbatim. Thematic analysis was conducted with a phronetic iterative approach using Atlas.ti software. Participants
included American adults who lived for more than six months of the year in an RV while traveling to different regions of the U.S. Participants were located in a variety of campgrounds in several states including Oregon, Wyoming, Colorado, New Mexico, Texas, and Arizona.
Results: Twenty-five RV-dwelling nomads participated in semi-structured interviews. Three overarching themes described the experiences of RVers: overwhelming logistics, don’t need healthcare, and orchestrating a web of care. Some of the barriers identified included difficulty vetting healthcare resources in unfamiliar locations, caregivers’ lack of understanding of the nomadic lifestyle, limited resources in rural areas, and rules limiting care and payment for care by state. Some of the facilitators identified included caregiver collaboration, telehealth, national chains with shared records, information and support from other RVers, and self-advocacy.
Discussion: RV-dwelling nomads are an understudied population that face complexity and barriers to healthcare access related to seeking care in unfamiliar locations, misunderstandings about their lifestyle, and policies that prevent the portability of healthcare across state lines. More research is needed to determine the most effective solutions to improve healthcare access for RV-dwelling nomads. In addition, the impact of healthcare policy decisions on people who are geographically mobile should be considered. |