This paper aims to contribute to the participatory tradition in health informatics by presenting a model for reflective participatory design emerging from qualitative fieldwork in a participatory project aimed to improve the health and wellbeing of older people in the northern periphery regions of Europe, through new mobile services. The model brings together two established processes in novel ways: systems development and user participation. Within each process three concepts are presented to facilitate discussion and reflection at the concept level, the process level and the integrated process level.