
KU Medical Center
WICHITA - Rural Kansans who thought they were just too far away from where medical research happens might be pleasantly surprised with the changes taking place at the Center for Clinical Research at the University of Kansas School of Medicine-Wichita (CCR).
Using telehealth, telephone and even the United States Postal Service, researchers at CCR are devising new ways to include more rural residents in their clinical trials.
āWeāre really excited about our rural outreach, about breaking down barriers for people that live in rural regions,ā said Tiffany Schwasinger-Schmidt, M.D., associate professor of internal medicine at the University of Kansas School of Medicine-Wichita and director of the CCR.
The CCR is a research facility on KU Medical Centerās Wichita campus, and it is one of the KU Medical Center Clinical and Translational Science Units (CTSUs) that provides services to researchers. Although it shares the same address as the Wichita campus, its separate entrance, dedicated parking and proximity to Interstate 135 allows rural residents easy access to its facility.
āClinical trials open up potential opportunities,ā Schwasinger-Schmidt said. āIn a lot of the clinical trials that we do, people have tried other treatments and they havenāt been successful, or there just havenāt been a lot of treatments available. Just having the opportunity to try something ā thatās a significant opportunity for patients.ā
Inside the CCR are a laboratory, pharmacy and two exam rooms as well as researchers and study coordinators. These scientists are tackling some of medicineās toughest challenges, including Alzheimerās disease, treatment-resistant depression and COVID-19 prevention and treatment.
Rural representation
People who live in rural areas have different environmental factors than those who live in urban or suburban areas, and those factors need to be studied in clinical trials, Schwasinger-Schmidt said.
āWe have different socio-economic areas that we live in, and we have different exposures to environmental components,ā she said. āWe have different stressors ā so many different things that interplay into our health, that define the social determinants of health.ā
K. James Kallail, Ph.D., associate dean for research for KU School of Medicine-Wichita, said rural Kansans no doubt have barriers to participating in clinical trials. āThese individuals usually live distant to academic hospitals and clinical researchers, yet they need representation, ā Kallail said. āEspecially in new drug development, their participation is needed to provide robust data on drug effectiveness and efficacy.ā
Thereās a myth that rural residents donāt want to participate in scientific research, which Schwasinger-Schmidt hasnāt found to be true.
āI think thereās a misconception that people who move to rural areas are looking for more solitude,ā she said. āAnd while there is some peacefulness and solitude out in the country, that doesnāt mean you shouldnāt have access to cutting-edge therapies. And just because you donāt choose the hustle and bustle of the city doesnāt mean that you donāt want to do your part for advancing science.ā
Schwasinger-Schmidt understands those motives because sheās lived them. As a girl growing up in Goodland, Kansas, the future doctor had to spend hours in the car to access medical care.
āIām a western Kansas girl, born and raised. And I know the challenges that people face living in those rural areas with access to health care, and especially access to clinical trials and research,ā she said.
Sheās also aware of the potential for perception problems when rural-centered research isnāt conducted in a rural area. āWichita is the biggest city within Kansas, so sometimes when I talk about rural outreach, people say, āBut youāre in the largest city in Kansas.ā But itās the connections to rural communities that matter, and really focusing on how we can help others.ā

Clinical trial participant Jo Dove and her husband, Kent, make bimonthly visits to the CCR from their home in rural Sedgewick, Kansas, population 1,603. The route is around one hour round-trip, but the retired couple said they donāt mind the drive.
āWhen you see each other every two weeks, you sit down and have conversations with (CCR personnel),ā Jo Dove said. āThey ask, āHow has your week been?ā It feels like a family conversing.ā
Jo has been part of multiple clinical trials studying Alzheimerās disease, and Kent participated in a COVID-19 study in 2021. Their visits to the CCR have easily reached the triple digits. Jo said sheās on her 84th visit for this particular clinical trial involving infusions of an investigational product.
āWhen you live in the country, you get used to going somewhere for services, whether it be for groceries or other places to shop,ā Kent explained. āTo travel down here is just a reason to go out to eat afterward.ā
Different strategies for outreach
The CCR has a variety of different strategies for clinical trial participants, including in-person, telehealth, and even via U.S. mail.
āWe have analyzed just how many visits are needed in a face-to-face environment,ā Schwasinger-Schmidt said. āAnd weāre considering the financial burden placed on rural participants who have to drive to Wichita, pay for transportation costs, and then maybe pay for lodging if an overnight stay is needed.ā
Instead of traveling to Wichita, rural residents can participate in some clinical trials via a secure video platform. āBefore the pandemic, using telehealth in clinical trials was unheard of,ā Schwasinger-Schmidt said. āThe participants came to our center to be seen for study visits. But the pandemic opened things up, and now we consider what we can do safely over a telemedicine platform.ā
For telehealth to be an equitable solution, however, all of Kansas needs affordable, high-speed internet access, she said. āIn some areas of Kansas, internet signals and cell phone signals are not always the most reliable. Solving this problem addresses the social issue of getting people better connected, not just for clinical trials but for other important opportunities.ā

One recent COVID-19 study named ACTIV-6 introduced Schwasinger-Schmidt (and clinical trial participants all over the state) to the concept of āvirtualā clinical trials using online forms and medication sent through the mail. Schwasinger-Schmidt led a statewide effort that mailed medications such as ivermectin to participants who met specific criteria. Follow-up was also conducted remotely.
Study coordinators tracked the participantsā daily diaries, which included when they took the medication, how they felt while taking it and how long it took COVID-19 symptoms to resolve.
āItās a great way to be able to reach out to everyone who wants to participate and to eliminate distance barriers,ā Schwasinger-Schmidt said.
Clinical trials such as the ACTIV-6 platform set the stage for future trials to use delivery via mail or courier, Schwasinger-Schmidt said. āI think there are going to be more and more opportunities to do remote work and break down barriers. These remote opportunities allow us to still take great care of people and advance medicine regardless of their physical location.ā
Rural outreach for Alzheimerās clinical trials
The Center for Clinical Research (CCR) in Wichita is currently running four different studies on Alzheimerās disease and regularly focuses 20-25% of its clinical trials on dementia research.
Tiffany Schwasinger-Schmidt, M.D., director of the CCR, said the current studies use a mixture of in-person visits and phone calls or telehealth videoconferencing. āParticipants will need to be seen in person for at least 50% of the time for our current trials,ā she said.
About half (46%) of all Alzheimerās disease clinical trial participants have identified themselves as living in rural areas.
āI have made it a priority to engage with rural communities to promote access to clinical trials research. This is especially important in the field of neurocognitive disorders, given the limited number of neurologists in the state of Kansas,ā Schwasinger-Schmidt said.
Eric Vidoni, Ph.D., associate professor of neurology at the University of Kansas Alzheimerās Disease Research Center, said that for new treatments to help as many people as possible, āour friends and family in rural and frontier Kansas need to be included.ā
He explained why that diversity was important. āIf a drug or treatment is difficult to produce, transport or administer, that drug may not work in a county that recently lost a trusted clinic or pharmacyā even if the drug is approved. āMaking sure people in rural and frontier counties are included in trials gives us an opportunity to identify those problems early.ā
Learn more about joining a clinical trial in Wichita.