Many eHealth technologies are known to have acceptance problems, which can be attributed to insufficiently meeting the needs of users (Eysenbach, 2008). To prevent dominance of experts when making decisions about development, and to account for the user and context, stakeholder participation is essential (Belt, Engelen, Berben, & Schoonhoven, 2010). In this so-called participatory development, stakeholders are involved during the entire development and evaluation process. These stakeholders include the users, but other stakeholders are essential for a proper development, implementation and evaluation as well. Merely involving users might cause a dominance of the user-perspective (Bødker, Kensing, & Simonsen, 2009) and can lead to overlooking the needs of other stakeholders who will use, implement, or be in any way involved with the technology.
Development ‘with’ instead of ‘for’ stakeholders entails their active involvement in activities related to the development, implementation and evaluation of eHealth. Their roles can range from informant to actual co-creator (Scaife, Rogers, Aldrich, & Davies, 1997; Yip et al., 2013). Stakeholders help to create the technology by means of being involved in activities like identifying their needs for the technology, improving the technology based on their input, or identifying critical issues for implementation (Carr, Howells, Chang, Hirji & English, 2009). However, participatory development does not always have to be about creating new technologies. Existing technologies can be re-designed and re-used in different contexts, and it is important that stakeholders are involved in that process as well.