title: Certified Nursing Assistants Balancing Family Caregiving Roles: Health Care Utilization Among Double- and Triple-Duty Caregivers.
abstract: This study examines how certified nursing assistants (CNAs) balancing family caregiving roles-child care (double-duty child caregivers), elder care (double-duty elder caregivers), and both child and elder care (triple-duty caregivers)-utilize health care services relative to nonfamily caregiving counterparts (formal-only caregivers).
  
  
  
  A sample of 884 CNAs from the Work, Family and Health Study was drawn on to assess the number of acute care (i.e., emergency room or urgent care facility) and other health care (i.e., outpatient treatment or counseling) visits made during the past 6 months.
  
  
  
  Double-duty elder and triple-duty caregivers had higher acute care utilization rates than formal-only caregivers. CNAs with and without family caregiving roles had similar rates of other health care visits.
  
  
  
  CNAs providing informal care for older adults have higher acute care visit rates. Given the increasing need for family caregivers and the vital importance of the health of the nursing workforce for the health of others, future research on how double- and triple-duty caregivers maintain their health amidst constant caregiving should be a priority.
authors.affiliation: Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park. nzd117@psu.edu.
authors.forename: Nicole
authors.initials: N
authors.lastname: DePasquale
authors.affiliation: Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park.
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Bangerter
authors.affiliation: Harvard School of Public Health Center for Population and Development Studies, Cambridge, Massachusetts.
authors.forename: Jessica
authors.initials: J
authors.lastname: Williams
authors.affiliation: Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park.
authors.forename: David M
authors.initials: DM
authors.lastname: Almeida
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D017028:Caregivers; D002648:Child; D002654:Child Care; D003376:Counseling / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009728:Nursing Assistants; D005791:Patient Care; D055815:Young Adult
keywords: Acute care; Combined caregiving roles; Family caregivers; Formal caregivers; Health care visits