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Background Chronic illnesses, such as Rheumatoid Arthritis (RA), are a growing burden on health care systems worldwide. Self-management emphasises the patient’s central role in managing their illness. This is pertinent given the majority of care is provided by the individual themselves; yet how individuals make sense of self-management in everyday life is largely unseen. Objective The purpose of this study was to capture the strengths and concerns of individuals with RA in self-managing their illness, raise awareness of their lived experience and spark a dialogue among stakeholders. Methods A community-based participatory approach, Photovoice, was adopted. A purposive sample of participants were tasked with taking photographs to represent the challenges and solutions to living with RA. Group workshops and semi-structured interviews were conducted to facilitate reflection, dialogue and analysis. Data analysis followed Braun and Clarke’s thematic analysis. Public exhibitions were held throughout the Autumn of 2019. Results Eight women and three men (n = 11) across suburban and urban regions of Ireland were recruited (mean age 57 years, disease duration 4–21 years). Participants identified four main themes which reflected the lived experience of self-managing RA: (i) I’m Here but I’m Not, (ii) Visible Illness, (iii) Medicine in All its Forms, (iv) Mind Yourself. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness. Solutions focused on improving psychological and emotional resilience, particularly through personal reflection and increased agency. Conclusions Our findings suggest that RA is experienced as a fluid relationship between states of masking and surfacing of illness shaped by contextual and situational factors. Photovoice was a highly effective tool to capture and communicate this complexity. Supporting increased agency among individuals with RA to control the (in)visibility of illness and disability can inform the development of future self-management support.

Objectives To determine 1) socio-demographic factors related to parent engagement in the NICU, and 2) determine if the Supporting and Enhancing NICU Sensory Experiences (SENSE) program increased parent engagement. Background Preterm birth results in significant health complications, necessitating infant hospitalization. This alters early sensory experiences which are further impacted by challenges parents face engaging in care 1 . Parent participation in appropriate sensory activities can improve infant developmental outcomes 2 . Methods Sixty-four infants born £ 32 weeks gestation were randomized to SENSE or standard of care. SENSE included parent education and specific amounts of age-appropriate sensory exposures for parents to conduct each day of hospitalization. Bedside logs were used to record parent engagement in providing sensory exposures to their infants. Results Being married (p=0.02) and having private insurance (p=0.003), a college degree (p=0.046) and fewer children (p=0.02) related to more parent engagement. The SENSE intervention was related to increased engagement for young mothers (p<0.001) and those living farther from the NICU (p<0.001) with trends toward more engagement among African-American parents (p=.07). Conclusion Those with high social risk are less likely to engage in the NICU, but the SENSE program increased engagement among some high-risk groups.