CORE Posters Fall 2025

Applying the No Wrong Door Model: Mapping Resources for Substance Use Disorder in Southwestern Virginia David Roach MPH B.S, Nonnie Komon B.S, Savannah Childers MA B.S, Nicholas Childers MA B.S, Pedro Mendoza MS B.S, Colleen Neff B.S, Colton Allison B.S, Jillian Bastyr B.S , Jess Nicholson MAT, Dr. Bernard Kadio MD PHD MPH

Edward Via College of Osteopathic Medicine, Blacksburg, VA

Group N

Conclusion

Methods

Abstract

o 3 key informant interviews were conducted via Zoom, with audio recording, and transcription, with 5 more interviews planned to be completed.

This study highlights critical barriers and points of disengagement for patients

This study aimed to map the patient journey for individuals with substance use

with SUD in the New River Valley as we have identified common gaps in care

disorder from the provider perspective . By gathering insights from key

o Data was collected through Microsoft Forms during interview.

continuity , common entry points, and points of disengagement.

informants , including healthcare providers, emergency medical services, recovery

o Qualitative Thematic analysis will be performed using NVivo

specialists, and community support workers.

The thematic analysis of the interviews gives crucial, actionable insights. The

interviews highlight some crucial areas of importance: legal concerns from patients,

Data Collection

NVivo Theme Analysis

Patient Journey Map

Consent + Interview

Recruitment

Using a qualitative design guided by the principle of thematic saturation, eight key

the importance of faith-based organizations , adverse childhood experiences and

informant interviews were planned to be conducted with stakeholders representing

community impacts. A key mention in the interviews was stigma and the War on

diverse professional roles.

Drugs that is contributing to the stigma. Also mentioned was the need for more field

Entry Points

work , continuity of care beyond recovery , and bridging between organizations. The

By mapping the patient journey through the perspectives of professional key

viewpoint of many of these providers and peers centered around the need to

informants, the goal was to provide actionable insights into the structural and social

individualize care and increased accessibility of support for each patient,

factors shaping access to and continuity of substance use disorder care in the New

mentioning barriers like transportation, housing, finances, and fear of judgment.

Drop-Off Points

Opportunities

River Valley of Southwest Virginia.

Patient Journey Map

Next Steps:

o Focus groups to create a patient journey map from a patient and community perspective. o Combine the perspectives and recommendations of both community providers and patients to look for opportunities for systemic improvement.

Introduction & Background

➢ Substance Use Disorder (SUD) continues to be a major public health crisis in the

New River Valley of Southwest Virginia, with individuals often meeting complex

Barriers to Care

“One of the biggest principles in harm reduction is to allow patients to lead the way and tell us what they need, and meet them where they are”

Outcomes

and fragmented pathways when seeking treatment and recovery support.

➢ The 2024 NRV Community Assessment shows that substance misuse rates have

Results

been climbing since 2018, along with a 105% increase in deaths by drug

“Participants shared [that coming to NRVCS] was their first experience of a medical provider treating them like a person."

overdoses in the past 5 years.

ENTRY POINTS

➢ Emergency Department, Peer Centers, Faith-Based Organizations, Incarceration

➢ The “No Wrong Door” Model utilizes an osteopathic, “whole person” approach to

DROP-OFF POINTS

Acknowledgements

ensure that patients receive appropriate and high quality care regardless of entry

➢ Post-ED, no follow up tracking , assumption of care completion

point into the system. The goals are to avoid fragmented systems that lead to

Group N would like to acknowledge a few individuals without whom this project would not have been possible.

BARRIERS TO CARE

patients not receiving care or high quality care.

➢ Transportation , Housing , Stigma, Wait times, Legal Concerns, Resource

We would like to thank Dr. Kadio and Ms. Nicholson for their guidance during the CORE course.

Invisibility

OUTCOMES

References

We would also like to thank Kinsey Weaver and Holly Lesko from the NRV Recovery Ecosystem for their help with this project and their unwavering support of those in the NRV community.

➢ Peer support, Medication Assisted therapy, return to use, disengagement

OPPORTUNITIES

➢ Centralized resource map, warm handoffs, SUD training and anti-stigma education,

VCOM IRB #2025-052 9/10/25

expand housing and mental health resources, trauma-informed care