Digital health adoption remains a challenge requiring engagement from patients, healthcare professionals, and family members. Participatory design (PD) enables stakeholders to co-create tools but the relationship among stakeholders influences power dynamics. We explored power dynamics in a series of PD workshops with patients, healthcare professionals and family members taking place in 4 different countries. Data was collected through participant observation, recordings, and facilitator interviews, then analyzed using French and Raven’s Bases of Power framework. Findings indicate that each stakeholder group holds distinct types of power that impact the design process. Patients brought referent and informational power derived from lived experiences. Healthcare professionals often wielded expert and legitimate power, while family members sometimes exerted coercive or reward power.