Closing the Gap: Clinical Trials and Community Health at the Center for Thriving Communities with Karenna Barmada

Hi! My name is Karenna Barmada, and I am a senior from Washington, D.C. studying Neuroscience with a Business of Health minor at Kenan-Flagler Business School. This spring, I had the opportunity to intern at UNC's Center for Thriving Communities through the Karen M. Gil Internship Program, supporting the CommunityRx-Kidney Health trial, a National Institute of Diabetes and Digestive and Kidney Diseases-funded randomized clinical trial examining the effect of a structured community resource navigation intervention on acute healthcare utilization among rural patients with chronic kidney disease. Additional information about the CommunityRx-Kidney Health trial can be found here. 

My undergraduate research experience has been largely concentrated in Dr. Sylvia Fitting's HIV neuroimmunology lab, where I developed a strong foundation in experimental methods and co-authored work on HIV-1 pathophysiology. That background shaped how I think about disease mechanisms, but it also exposed a gap in my own training. The care delivery work I encountered through a government relations internship at ViiV Healthcare was specific to HIV care, a system I came to understand reasonably well. General chronic disease management, rural primary care infrastructure, and the operational complexity of connecting patients to community resources were largely outside my frame of reference. My Business of Health coursework at Kenan-Flagler deepened that awareness: the distance between a clinical finding and a scalable, sustainable intervention is not only a scientific challenge but an operational and systems one. The Gil Internship felt like the right opportunity to engage with that directly. 

The CommunityRx-Kidney Health trial offered exactly that kind of exposure. My role sat within trial operations and regulatory coordination, working under the mentorship of Kristen Witkemper, the senior clinical research coordinator. The majority of my responsibilities centered on Institutional Review Board regulatory binder management: processing modifications for personnel changes, consent and Health Insurance Portability and Accountability Act form revisions, eligibility screener additions, and recruitment flyer updates, while maintaining the ongoing roster. I also developed and refined standard operating procedures for recruitment and intervention workflows ahead of the trial launch, copyedited the CommunityRx-Kidney Health trial protocol, supported Research Performance Progress Report narrative and budget justification preparation for the National Institute of Diabetes and Digestive and Kidney Diseases, and tested data collection instruments for trial readiness. 

What this work made clear to me is something my Business of Health coursework had introduced conceptually but that only became concrete in practice: implementation fidelity is not a given. Delivering a consistent intervention across geographically dispersed clinic sites requires the kind of careful procedural groundwork that rarely gets acknowledged in a published paper. Regulatory documentation, standardized workflows, and rigorous protocol adherence are not administrative formalities. They are the conditions under which a study can actually function at scale. Understanding that shifted how I think about what research infrastructure is and why it matters. 

I came into this internship with strong interests in health policy and pharmaceutical strategy, fields where I had always seen my neuroscience training and business background as complementary. I leave with a more textured understanding of what those interests require at the level of implementation. The operational complexity behind a trial like CommunityRx-Kidney Health is invisible in the final publication, but it determines whether the science ever reaches the people it was designed to help.  

I am deeply grateful to Kristen Witkemper and the entire CommunityRx-Kidney Health research team for their mentorship and for entrusting me with substantive work throughout the semester. Thank you as well to Dr. Steve Buzinski and the Karen M. Gil Internship Program for making this experience possible. My time at the Center for Thriving Communities gave me exactly what I was hoping for, and more than I anticipated.