Co-design has been widely applied to develop interventions supporting behavior change. While numerous co-design propositions have been developed, applying these in practice often leads to difficulties and tensions. This study aims to review the co-design propositions and understand the dilemmas when applying them. A literature review was conducted, and twelve co-design propositions were identified after qualitative analysis. The study found that some co-design propositions conflict because they align with an idealistic versus a realistic perspective. By studying these conflicts indepth, seven dilemmas were identified at the intersection of realist and idealist propositions. Implications of the findings on design for behavior change were discussed, and this paper serves as a starting point to help researchers and practitioners identify, articulate, and navigate these dilemmas to achieve successful co-design outcomes.

Long-term care is defined as a variety of services designed to meet a person’s health and personal care needs which help people live as independently and safely as possible when they can no longer perform everyday activities on their own. Depending on the needs and social context of the patient, long-term care can be provided in different places by different kinds of formal or informal caregivers, either at home or in an institutionalised setting, which from here on we will refer to as the nursing home. In all these fields, technology has an increasing role to play.