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Objective:  To identify the key mechanisms, contexts, and outcomes that drive the successful participatory co-design of assistive technologies.  Method:  A rapid realist review was conducted using a systematic search strategy. After screening, a final set of 28 articles were included. Articles were analyzed for evidence relevant to our initial program theory (IPT), and context-mechanism-outcome configurations were developed, resulting in a revised program theory.  Results:  All 28 articles included were highly relevant to the IPT, and had sufficient detail regarding the process of participatory co-design. The findings of this review highlight several key context-mechanism-outcome configurations as potential patterns in the data under the two dimensions of the evolving program theory:  knowledge integration  and the  ethico-political  dimension.  Discussion:  This review revealed the key mechanisms of  mutual awareness, mutual learning, trust , and  reciprocity  that need to be taken into account in AT development and assessment. We concluded that participatory co-design requires a restructuring of power relations between end-users and those traditionally in control of technology design. These findings inform the development and assessment of AT for older adults and help guide policy/decision-makers to move forward with the now urgent agenda for scale-up and spread, initiated by the burning platform of the COVID-19 pandemic.

gerontology and geriatric medicine

Supporting Healthy Aging through the Scale-Up, Spread, and Sustainability of Assistive Technology Implementation: A Rapid Realist Review of Participatory Co-Design for Assistive Technology with Older Adults