School asthma expert Dr. Lynn Gerald lightens his load

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Lynn B. Gerald, PhD, MSPHis used to lifting heavy loads.

With roles from Distinguished Outreach Faculty and the Zuckerman Family Endowed Chair in Prevention and Lifestyle Medicine at Mel and Enid Zuckerman College of Public Health at the University of Arizonalightening her workload in preparation for a year-long sabbatical beginning in July was the opposite of the preparation she needed to become a national powerlifter record holder.

As weightlifters steadily increase their weight load to become stronger and more comfortable with the added burden, offloading academic duties is what Dr. Gerald is committed to now as she prepares to devote time to study how to better structure clinical trials and public health research to be more effective.

“I always trained early in the morning before work,” Dr. Gerald said. “I train six days a week for about two hours. When I competed in powerlifting, it focused on the three main lifts – bench, squat, and deadlift – with a few prop lifts about five times a week. I also ran and did metabolic conditioning 3-5 times a week, focusing more on weights closer to competition.

Dr. Gerald’s dedication to fitness goes beyond powerlifting. She is certified in aerobics, CrossFit and personal trainer. She even competed as a ballroom dancer.

Stay fit for life

His lifelong commitment to a healthy lifestyle began after completing his undergraduate studies at the University of Alabama at Birmingham.

Dr. Gerald with some of his powerlifting awards.  She held state and national records, albeit briefly, in three categories.  Among these was the strict national biceps curl record for her age group, which she won in 2013. “I had been a varsity cheerleader at UAB, and after graduating, it was like, ‘Well, now what?’ I always wanted to stay active. My husband, Joe, was a medical student at the University of South Alabama in Mobile. I started aerobics and got certified to teach aerobics, and got certification to be a personal trainer and do weights. It was my second job in grad school. I got into weightlifting that way.

The highlight of Dr. Gerald’s lifting career came when she placed second at the world championship in 2013. She was named Arizona State’s 2013 Master Lifter of the Year after winning the titles of State and nationals. She set state records in the squat (138 pounds) and bench press (110 pounds) and a national record for the strict bicep curl (77.15 pounds). The records didn’t last long, she admits.

“It was for a very short period of time, and I will just say that we weren’t many in the older ladies category. So, yes, I really like weightlifting. But, since then, I had hip replacement surgery (in 2018) and knee issues, so I don’t compete anymore,” she said.

These days, she still lifts and does CrossFit, but has pared back her professional portfolio.

Asthma Inhaler Awareness

In her own research, she has focused on improving asthma care in schools for 25 years. Dr. Gerald is a nationally recognized expert and helped pass a 2017 law in Arizona to allow any school employee to dispense stock inhalers to any child in respiratory distress. A standard inhaler is an inhaler that is not prescribed to a specific child and can be used by any child in the school.

Dr. Gerald testifies in the Arizona State Legislature in 2017 to promote wider adoption of stock inhaler programs for students with asthma in schools across the state and loosen rules on who could administer them.

Dr. Gerald consults on enacting or updating similar laws in other states. Seventeen states have adopted such measures, up from seven since Arizona adopted its version. She recently testified in Texas and Maryland, and counts Utah and Illinois among her recent successes. For this, she was recognized in February as the 2022 Robert F. Lemanske, Jr, MD, FAAAAI Annual Lecture Presenter at the American Academy of Allergy, Asthma and Immunology (AAAI) Annual Conference, as well as the UArizona Distinguished Outreach Faculty Award last year.

What interests her about asthma, she said, is that so many treatments work well, but getting people to take these drugs on a daily basis is a daunting task. The same goes for getting them to avoid activities or situations that act as triggers. And many sufferers don’t always keep inhalers on hand.

During her sabbatical, Dr. Gerald will explore research methodologies to improve public uptake of recommended best practices in pulmonary studies.

“One of the fun things about stock inhalers for me was that I was the booster chair for my son’s high school band at Catalina Foothills. He is now a music student at ASU. But we had the largest group in the state with about 200 kids,” Dr. Gerald said. “And, so, of course, 10% of them were going to have asthma. And every time we had a practice or a show, I was in charge of the medication. There would be five kids having an exacerbation of asthma and no one had their inhaler”, so legislation on common inhalers allowed him to provide one.

A native of Birmingham, Alabama, she began her asthma research as a junior faculty member at UAB under Bill Bailey, MD, founder of the Lung Health Center, and one of the first researchers to receive NHLBI funding to study asthma in schools.

“I started helping him with many of his studies and fell in love with the asthma school work. I realized how much there was to do, how much the schools in my own town were different for some children and for me, and what a difference a school can make to children’s health,” said Dr Gerald.

Sabbatical goals

For her sabbatical, she plans to read, take online courses, and travel to learn about the latest in “implementation research.” But first, she’ll be celebrating her 32nd wedding anniversary — also in July — with Joe Gerald, MD, Ph.D.. A colleague from the Zuckerman College of Public Health, he was the chief compiler of the weekly Arizona COVID-19 forecast data used to guide policy makers statewide. He is a frequent co-author with her on published articles.

An ongoing box ventilator filter prototype project that Dr. Gerald has received funding for will contribute to a larger effort to reduce pediatric asthma disparities in the Navajo Nation.  Asthma rates among reserved children are 14 to 18 percent compared to 10 percent nationally, she said.  Prototype partners include UC Berkely and Navajo Technical University.

Implementation research, said Dr. Lynn Gerald, involves the study of methods to promote the systematic adoption of proven clinical treatments, practices, organizational and management interventions into routine practice to improve the health. This includes ways to encourage greater adherence to the use of asthma inhalers.

“That’s really what I’ve been doing all my life, trying to get interventions to work in a community setting outside of a clinical trial. But the methodology and things about how to do implementation science have changed a lot, so I’m going to look into that,” she said.

Dr. Gerald will also continue to work on his own ongoing research projects, including one funded by a small grant from the Southwestern Environmental Health Science Center to UArizona to develop a prototype box fan filter for use on the Navajo Nation to reduce air particles from wood-burning stoves commonly used in rural areas. Partners include the University of California, Berkeley and Navajo Technical University in Crownpoint, NM, which will produce the filters.

“You just take the fan out of the box, put a filter in it and you have a very inexpensive solution. It appears that this can reduce indoor air pollution from cookers by around 90%. This is a huge problem for Navajo children and adults with respiratory problems. For many years people have tried to improve this situation, including stove exchange programs to install new, cleaner and more efficient ones,” said Dr Gerald.

“What’s cool is that it’s cheap. It is developed and produced locally. And people can use their stoves the way they’ve always used them. Our long-term goal is to secure a larger grant to see if we can further reduce indoor air contamination to improve asthma outcomes in children and adults.

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