# Compassion Disparities in Primary Care: A Mixed Methods Pilot Study

> **NIH AHRQ R03** · ROWAN UNIVERSITY · 2024 · $51,031

## Abstract

Project Summary/Abstract
Background: Healthcare disparities are meaningful differences in healthcare quality linked to patient race,
ethnicity, socioeconomic status (SES), or other factors. There is a vital element of healthcare quality with a
paucity of data on disparities: compassion from treating clinicians. Compassion is highly valued by patients and
essential for high quality healthcare. For example, a lack of clinician compassion could contribute to patient
distrust of the healthcare system, which is associated with patient non-adherence to health maintenance and
treatment recommendations. Understanding compassion disparities is vital for improving healthcare equity.
Health disparity populations may receive less compassion from clinicians due to implicit bias and/or racism.
However, our prior research has shown that conventional after-care patient experience (satisfaction) surveys
are prone to nonresponse bias and thus are inadequate to test for compassion disparities. Anonymous, real-
time, point-of-care assessments are needed. This is a critically important knowledge gap for healthcare equity.
Compared to nondisparity populations, we hypothesize that (1) patients in health disparity populations
experience less compassion from clinicians, (2) less compassion for health disparity populations mediates
healthcare system distrust, and (3) salient clinician behaviors that communicate compassion (or lack of) from
the patient perspective differ for health disparity populations. Objectives: In a diverse population of primary
care patients, (1) we will test for differences in patient experience of clinician compassion between White
patients without low SES and (a) Black or African American, (b) Hispanic or Latinx, or (c) low SES patients.
(2) We will test if patient experience of clinician compassion mediates differences in healthcare system distrust
between the populations above. (3) From the patient perspective, we will identify differences in salient clinician
behaviors that communicate compassion (or lack of) between the populations above. Methods/environment: In
a network of 26 diverse academic primary care clinics, we will perform a cross-sectional mixed methods cohort
study collecting anonymous, real-time, point-of-care assessments of clinician compassion from the patient
perspective (n=350). We will use the 5-Item Compassion Measure, a semi-quantitative research tool that we
validated in three prior studies including real-time evaluation. We will test for differences in the populations
above adjusted for patient, system, and clinician-level factors. We will also use the validated Healthcare
System Distrust Scale to test if clinician compassion mediates (i.e., is on the causal pathway for) patient
distrust of the healthcare system for the populations above. We will use open-ended questions (i.e., qualitative
methods) to identify salient differences in clinician behaviors that communicate (or detract from) compassion
from the patient perspect...

## Key facts

- **NIH application ID:** 10878795
- **Project number:** 5R03HS029414-02
- **Recipient organization:** ROWAN UNIVERSITY
- **Principal Investigator:** Stephen Walter Trzeciak
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $51,031
- **Award type:** 5
- **Project period:** 2023-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10878795

## Citation

> US National Institutes of Health, RePORTER application 10878795, Compassion Disparities in Primary Care: A Mixed Methods Pilot Study (5R03HS029414-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10878795. Licensed CC0.

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