# Content Validity, Feasibility, and Acceptability of the Neurosense PremmieEd Programme, a South African Premature Parenting Education Intervention for the NICU Parent: A Hybrid Focus Group Discussion Method

## TL;DR

The NeuroSense PremmieEd programme was adapted for South African NICU parents using feedback to ensure it was feasible, acceptable, and culturally relevant.

## Contribution

A novel hybrid focus group method was used to adapt a parenting education programme for South African NICU parents, ensuring cultural relevance and feasibility.

## Key findings

- The NeuroSense PremmieEd programme was found to be feasible, acceptable, and culturally relevant for South African NICU parents.
- Hybrid focus group discussions improved content clarity, emotional sensitivity, and accessibility of the programme.
- Low-cost digital formats were suggested to enhance accessibility and standardization of the programme.

## Abstract

What are the main findings?
The NeuroSense PremmieEd programme was adapted for South African NICU parents using a hybrid focus group method and found to be feasible, acceptable, and culturally relevant.Iterative feedback from mothers, clinicians, and experts led to improvements in content clarity, emotional sensitivity, readability, and accessibility.

The NeuroSense PremmieEd programme was adapted for South African NICU parents using a hybrid focus group method and found to be feasible, acceptable, and culturally relevant.

Iterative feedback from mothers, clinicians, and experts led to improvements in content clarity, emotional sensitivity, readability, and accessibility.

What are the implications of the main findings?
Hybrid focus group approaches can effectively inform the development of parenting education programmes in resource-constrained NICU settings.Structured, culturally aligned educational interventions have the potential to support parents of premature infants, improving preparedness and engagement in care.

Hybrid focus group approaches can effectively inform the development of parenting education programmes in resource-constrained NICU settings.

Structured, culturally aligned educational interventions have the potential to support parents of premature infants, improving preparedness and engagement in care.

Background: Parent education is a key component of family-centred care in neonatal intensive care units (NICUs). It supports positive parent-infant interactions, reduces parental stress and anxiety, and contributes to shorter hospital stays. Objectives: This paper reports on the adaptation of a South African parenting education intervention for parents of premature infants in the NICU: the NeuroSense PremmieEd programme. The study aimed to demonstrate the programme’s content validity, feasibility, and acceptability for preterm parent–infant dyads in public hospital NICUs, using a hybrid focus group discussion (FGD) method. The programme was based on an existing intervention and informed by literature on the components of parenting educational programmes and empirical data on parental expectations. Methods: A qualitative, iterative refinement process was undertaken using hybrid-format FGDs. A conceptual FGD was held during the design phase, followed by two consensus FGDs after pilot testing (reported separately). Stakeholders included end-users (mothers), clinicians, an instructional designer, a neurodevelopmental care expert, and programme facilitators. Results: The first FGD reviewed draft version 0.1 of the programme, confirming content relevance and clarity, while recommending adjustments, such as module integration, cultural and language alignment, and visual aids to support comprehension. Version 0.2 was then ready for pilot testing (reported elsewhere). The second and third FGDs led to refinements addressing emotional sensitivity in terminology, improved layout and readability, and the addition of home care guidance. Stakeholders highlighted the potential use of low-cost digital formats to enhance accessibility and standardisation. These revisions informed the final version 0.3. Conclusions: The hybrid FGD approach enabled input from diverse and geographically dispersed stakeholders. The NeuroSense PremmieEd programme was found to be feasible and acceptable by both mothers and healthcare professionals, supporting its suitability for broader implementation in resource-constrained settings.