Pilot Implementation of the NeurPilot Implementation of the NeuroSense PremmieEd Parenting Educational Programme for Parents with Infants in the Neonatal Intensive Care Unit: A Sequential Cohort Design

Introduction: Preterm birth and neonatal intensive care unit (NICU) admission may elevate parental stress and impair early parent-infant interaction. In low-resource settings, where staff and resources are limited, parental education programmes are often also limited, further complicating care engagement. This study piloted the NeuroSense PremmieEd parenting educational programme to assess its preliminary impact on maternal stress and knowledge in a South African public-sector NICU. Objectives: This study aims to pilot a contextually relevant parenting education intervention to enhance parental understanding of preterm infant behaviour, strengthen parents’ capacity to interpret and respond sensitively to infant cues, and reduce parental stress during NICU admission. Methodology: This sequential cohort pilot study involved 60 mothers of preterm infants (gestational age 24–36 weeks) admitted to two comparable NICUs. Mothers (aged 18–45 years) were allocated to three groups. Arm 1 received standard care (n = 20), Arm 2 received a printed educational booklet (n = 20), and Arm 3 received the booklet plus a facilitated education session (n = 20). Pre- and post-intervention data were collected using the Knowledge of Preterm Infant Behaviour (KPIB) questionnaire and the Parental Stressor Scale: NICU (PSS:NICU). Descriptive statistics were used to explore differences across arms.Results: Knowledge scores measured with the KPIB tool showed a positive trend across all groups, with the greatest improvement observed in Arm 3; however, changes were not statistically significant (p = .176). Maternal stress measured using the PSS:NICU increased significantly over time across all groups (F(1, 57) = 8.40, p = .005), with Arm 3 consistently reporting the lowest stress at both timepoints. The overall rise in stress likely reflects the cumulative burden of prolonged NICU exposure, including infant health concerns, environmental stressors, and the demands of acquiring new caregiving knowledge and skills. Discussion: The facilitated intervention was associated with a trend towards improved maternal knowledge of preterm infant behaviour. This pilot highlighted the potential of structured, culturally relevant education to support early parenting in a public sector neonatal intensive care unit in South Africa. Maternal stress levels remained high across all groups. While this finding may be due to parent’s experience of changes in infant medical condition, fatigue, and other factors, it was not investigated in the study and therefore warrants further exploration in future work. Conclusion: The NeuroSense PremmieEd programme shows promise in improving maternal understanding of preterm infant behaviour. The results highlight the need for further adaptation of content delivery, inclusion of diverse populations (e.g., by preterm category) and scalable, low-resource approaches to improve engagement and long-term outcomes.