{
  "abstract": "Introduction Delayed cord clamping (DCC) is an evidence-based intervention that reduces mortality, anaemia and disability in infants born <37 weeks’ gestation who do not require immediate resuscitation. However, it is neither reliably recorded nor routinely implemented in Australia. The Wait a Minute or More (WAMM) study aims to reduce this gap between the evidence and practice by integrating timely sharing of cord clamping data with Evidence-based Practice for Improving Quality methods to increase the proportion of preterm infants receiving DCC for 60 s or longer (DCC60).Methods The WAMM study is a pragmatic stepped wedge cluster randomised trial (SW-CRT), informed by the Integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. Up to 20 Australian maternity hospitals will participate in this pragmatic SW-CRT to evaluate if in ( Population) infants <37 weeks’ gestation who do not need resuscitation, does (Intervention) the WAMM intervention (sharing of anonymised data on DCC60, together with a locally adapted quality improvement (QI) programme), compared with (Control) sharing of anonymised data on DCC60 alone, increase (primary Outcome) the proportion of infants receiving DCC60? At the end of 72 weeks, all sites will complete an 8-week period without the WAMM intervention to evaluate if implementation of DCC is sustained. Alongside the SW-CRT, an embedded process evaluation will assess the fidelity, acceptability, mechanisms of action and contextual barriers and enablers of the WAMM intervention.Discussion Using the stepped wedged design and guided by an explicit implementation framework (i-PARIHS), WAMM will provide information on the effectiveness and transferability of a locally adapted QI method to improve DCC60. If proven effective, ultimately scaling up the WAMM intervention globally will greatly improve childhood anaemia, death, disability and long-term costs.Trial registration number ACTRN12624000035527.",
  "authors": [
    {
      "affiliations": [
        "NHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia",
        "Grace Centre for Newborn Intensive Care, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia"
      ],
      "name": "Himanshu Popat"
    },
    {
      "affiliations": [
        "NHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Kristy P Robledo"
    },
    {
      "affiliations": [
        "NHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Sarah Finlayson"
    },
    {
      "affiliations": [
        "NHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Melinda Cruz"
    },
    {
      "affiliations": [
        "NHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Angela Cavallaro"
    },
    {
      "affiliations": [
        "NHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Alpana Ghadge"
    },
    {
      "affiliations": [
        "Royal Hobart Hospital, Hobart, Tasmania, Australia",
        "Burnet Institute, Melbourne, Victoria, Australia",
        "University of Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Naomi Spotswood"
    },
    {
      "affiliations": [
        "Women and Kids Theme, South Australian Health and Medical Institute, the Adelaide Medical School and the Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia"
      ],
      "name": "Amy K Keir"
    },
    {
      "affiliations": [
        "Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia",
        "University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Christoph Lehner"
    },
    {
      "affiliations": [
        "Mater Research, Mater Research Institute/University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Sailesh Kumar"
    },
    {
      "affiliations": [
        "Hudson Institute of Medical Research, Dept of Pediatrics, Monash University, Melbourne, Victoria, Australia"
      ],
      "name": "Graeme R Polglase"
    },
    {
      "affiliations": [
        "Royal Darwin Hospital, Darwin, Northern Territory, Australia"
      ],
      "name": "Dennis Bonney"
    },
    {
      "affiliations": [
        "Auckland City Hospital, Auckland, New Zealand"
      ],
      "name": "Malcolm Battin"
    },
    {
      "affiliations": [
        "The Kids Research Institute Australia, The University of Western Australia, Perth, Western Australia, Australia"
      ],
      "name": "Tobias Strunk"
    },
    {
      "affiliations": [
        "Neonatal Intensive Care, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia",
        "Charles Perkins Centre and Reproduction and Perinatal Centre, The University of Sydney, Camperdown, New South Wales, Australia"
      ],
      "name": "Adrienne Gordon"
    },
    {
      "affiliations": [
        "Pediatrics, University of Alberta, Edmonton, Queensland, Canada"
      ],
      "name": "Khalid Aziz"
    },
    {
      "affiliations": [
        "Flinders University, Adelaide, South Australia, Australia"
      ],
      "name": "Gillian Harvey"
    },
    {
      "affiliations": [
        "School of Women's and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia",
        "Newborn Care, Royal Hospital for Women, Sydney, New South Wales, Australia"
      ],
      "name": "Kei Lui"
    },
    {
      "affiliations": [
        "NHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "William O Tarnow-Mordi"
    }
  ],
  "title": "Wait a Minute or More (WAMM): a pragmatic stepped wedge cluster randomised implementation trial assessing the effect of a quality improvement programme on the proportion of infants achieving delayed cord clamping more than 60 s in infants <37 weeks’ gestation in up to 20 maternity hospitals",
  "uid": "113c5f7c-d0fa-5d1f-9970-75fb9e5f8184"
}