Designing a Health-oriented Lifestyle Package for Children with ADHD Based on a Qualitative Needs Analysis with a Systematic Review of National and International Articles
Journal of Pizhūhish dar dīn va Salāmat (i.e., Research on Religion & Health),
Vol. 12 No. 1 (2026),
24 Khordad 2026
,
Page 62-79
https://doi.org/10.22037/jrrh.v12i1.47541
Abstract
Background and Objective: Attention‑deficit/hyperactivity disorder is one of the most common childhood disorders and can negatively affect children’s academic, behavioral, and emotional functioning. Alongside conventional treatments, non‑pharmacological and health‑oriented lifestyle approaches may play an effective complementary role in reducing symptoms and promoting mental health. Despite the importance of this issue, comprehensive and evidence‑based intervention packages for children with attention‑deficit/hyperactivity disorder remain limited. Therefore, the present study aimed to design a health‑oriented lifestyle package for children with attention‑deficit/hyperactivity disorder based on qualitative needs analysis through a systematic review of the scientific literature.
Methods: This study was conducted using a qualitative descriptive–analytical approach. In the first stage, data were extracted and qualitatively analyzed through a systematic review of articles related to attention‑deficit/hyperactivity disorder (ADHD), health‑oriented lifestyle, and children’s needs assessment. Scientific sources were searched on Magiran, Scientific Information Database of the Academic Center for Education, Web of Science, Scopus, and PubMed databases. After identifying the key themes related to children’s needs, essential components required for designing the package were extracted. Subsequently, the health‑oriented lifestyle package was developed, and its content validity was reviewed and confirmed by experts in child psychology and traditional medicine. In the present study, all ethical considerations were observed, and no conflicts of interest were reported by the authors.
Results: The findings indicated that the main needs of children with ADHD within a health‑oriented lifestyle framework include climate conditions, nutrition, physical activity, sleep, elimination of bodily waste, and management of negative emotions. Accordingly, the package components included exposure to nature, an appropriate dietary plan, regular physical activity, improvement of sleep quality, and supportive interventions for managing constipation, anxiety, and low mood.
Conclusion: The results suggest that qualitative needs analysis can provide an appropriate foundation for designing a comprehensive health‑oriented lifestyle package for children with ADHD and may be used as a complementary approach alongside conventional treatments.
- Attention deficit/ Hyperactivity disorder
- Health promotion
- Qualitative research
- Lifestyle
How to Cite
References
1. Ayano G, Yohannes K, Abraha M. Epidemiology of attention–deficit/hyperactivity disorder (ADHD) in children and adolescents in Africa: a systematic review and meta–analysis. Ann Gen Psychiatry. 2020; 19(21):1-10.
2. Cortese S, Kelly C, Chabernaud C, Proal E, Di Martino A, Milham MP, et al. Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies. American Journal of Psychiatry. 2012;169(10):1038-55.
3. Sibley MH, Mitchell JT, Becker SP. Method of adult diagnosis influences estimated persistence of childhood ADHD: a systematic review of longitudinal studies. The Lancet Psychiatry. 2016;3(12):1157-65.
4. Hassanzadeh S, Amraei K, Samadzadeh S. A meta-analysis of Attention Deficit/Hyperactivity Disorder prevalence in Iran. Empowering Exceptional Children. 2019;10(2):165-77. (Full Text in Persian)
5. Cormier E. Attention Deficit/Hyperactivity Disorder: A Review and Update. Journal of Pediatric Nursing. 2008;23(5):345-57.
6. Shrestha M, Lautenschleger J, Soares N. Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: a review. Transl Pediatr. 2020;9 (Suppl 1): 114-24.
7. Shier AC, Reichenbacher T, Ghuman HS, Ghuman JK. Pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: clinical strategies. Journal of central nervous system disease. 2013;5: JCNSD. S6691.
8. Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, et al. Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American journal of psychiatry. 2013;170(3):275-89.
9. Wolraich ML, Hagan JF, Allan C, Chan E, Davison D, Earls M, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4).
10. Brown TE. Attention-deficit disorders and comorbidities in children, adolescents, and adults: American Psychiatric Publishing, Inc;2000.
11. Gupte-Singh K, Singh RR, Lawson KA. Economic burden of attention-deficit/hyperactivity disorder among pediatric patients in the United States. Value in Health. 2017;20(4):602-9.
12. Nguyen JT, Srivastava SB. The Synergy of Mediation and Lifestyle Medication: A New Horizon in Mental Health Treatment. Am J Lifestyle Med. 2024;18(2):186-8.
13. Ghanbari M, Delpasand K, Ghanbari A. Inclusion of Traditional and Complementary Medicineinthe United Nations Strategy and the World Health Organization. Medical History Journal. 2020;11(41):7-22. (Full Text in Persian)
14. Organization WH, Wen-Chieh Ce. The promotion and development of traditional medicine: World Health Organization;1978.
15. Persian Medicine and the Development of Theorizing in Today's Medical World. Iranian Journal of Culture and Health Promotion. 2021;4(4):455-64.
16. Biglari H, Dargahi A, Vaziri Y, Ivanbagh R, Hami M. Food Safety and Health from the Perspective of Islam Summary. Journal of Pizhūhish dar dīn va salāmat. 2020;6(1):131-43.
17. Asghari P, Gaffari M. The Approach of Islam Regarding toward the Role of Physical Activity in Maintaining the General Physical Health of the Society. Journal of Pizhūhish dar dīn va salāmat. 2024;10(2):131-40. (Full Text in Persian)
18. Moradpur R, Rezaei-Tavirani M, Ahmadi NA, Nakhaei-Moghadam M .Religion and health protection; A reflection on the necessity of interdisciplinary interactions between jurisprudence and the medical sciences. Journal of Pizhūhish dar dīn va salāmat. 2025;10(4):113-27. (Full Text in Persian)
19. Naseri M. Maintaining health from the perspective of traditional Iranian medicine. Tehran: Iranian traditional medicine publications. 2016:22. (Full Text in Persian)
20. Shareghfarid E, Sangsefidi ZS, Salehi-Abargouei A, Hosseinzadeh M. Empirically derived dietary patterns and food groups intake in relation with Attention Deficit/Hyperactivity Disorder (ADHD): A systematic review and meta-analysis. Clinical nutrition ESPEN. 2020;36:28-35. (Full Text in Persian)
21. Ola C, Gonzalez E, Tran N, Sasser T, Kuhn M, LaCount PA, et al. Evaluating the Feasibility and Acceptability of the Lifestyle Enhancement for ADHD Program. J Pediatr Psychol. 2021;46(6):662-72.
22. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology. 2006;3(2):101-77.
23. sheikhzade M, Baniasad R. Thematic Analysis: Concepts, Approaches, and Applications. Tehran: Logos.; 2021. (Full Text in Persian)
24. Lawshe CH. A quantitative approach to content validity. Personnel psychology. 1975;28(4):563-73.
25. Hyrkäs K, Appelqvist-Schmidlechner K, Oksa L. Validating an instrument for clinical supervision using an expert panel. International Journal of nursing studies. 2003;40(6):619-25.
26. Hood M, Baumann O. Could Nature Contribute to the Management of ADHD in Children? A Systematic Review. International Journal of Environmental Research and Public Health. 2024;21(6):736.
27. Barrable A, Booth D, Adams D, Beauchamp G. Enhancing nature connection and positive affect in children through mindful engagement with natural environments. International journal of environmental research and public health. 2021;18(9):4785.
28. de Vries S, Verheij R. Residential green space associated with the use of attention deficit hyperactivity disorder medication among Dutch children. Frontiers in Psychology. 2022;13:948942.
29. Faber Taylor A, Kuo FE. Could exposure to everyday green spaces help treat ADHD? Evidence from children's play settings. Applied Psychology: Health and Well‐Being. 2011;3(3):281-303.
30. Faber Taylor A, Kuo FE. Children with attention deficits concentrate better after walk in the park. Journal of attention disorders. 2009;12(5):402-9.
31. Kuo FE, Faber Taylor A. A potential natural treatment for attention-deficit/hyperactivity disorder: evidence from a national study. American journal of public health. 2004;94(9):1580-6.
32. Sardar MA, Yousefi M, Mohammadi M R, Sayyah M. Study of the relationship between the prevalence of sports injuries and athlete’s temperament from the perspective of Iranian traditional medicine in. jiitm 2016; 7(2) :201-6. (Full Text in Persian)
33. Sun W, Yu M, Zhou X. Effects of physical exercise on attention deficit and other major symptoms in children with ADHD: A meta-analysis. Psychiatry Research. 2022; 311:114509.
34. Rasoli A, Namazi zadeh M, Shams A. The Effect of Aerobic Activity with Low and Moderate Intensity on Executive Functions and Selective Attention in Children with Attention-Deficit/ Hyperactivity Disorder (ADHD). Journal of motor behavior. 2022;14(48):63-82. (Full Text in Persian)
35. Abedi A, Kazemi F, Shooshtari M, Golshani Monazzah F. The Effect of Aerobic Exercises on the Visual and Auditory Attention of Pre-school Boys with ADHD in Isfahan in 2009–2010. Psychology of exceptional people. 2012;2(7):133-52. (Full Text in Persian)
36. Sabzevari H, Parvinpor S, Arsham S. Effect of rhythmic exercises with music on anxiety, depression and hyperactivity/attention deficits disorder in primary school children. Razi Journal of Medical Sciences.2020; 26(11): 43-52. (Full Text in Persian)
37. Mirhoseini M, Saberi Kakhki A, Arabi M, Jalali N. The Effect of balance exercises on the sustained attention in boys between 710 years with Attention Deficit / Hyperactivity Disorder (ADHD) in Kerman Sport Psychology. 2021;6. (Full Text in Persian)
38. Mollazadeh M, Gharayagh Zandi H, Rostamizadeh M. Effectiveness of yoga exercise training in visual and auditory attention in boys with attention deficit hyperactivity disorder. Razi Journal of Medical Sciences. 2018; 25(8):52-61. (Full Text in Persian)
39. Eskandarnejad M, Rezaei F, Mobayen F. Effect of a Course of Basketball Training Program on ADHD Children’s Sustained Attention. Movement behavior. 2016;8(25):139-52. (Full Text in Persian)
40. Saber Z, Kowsari N, Alimohammadi N. The effect of gymnastics on symptoms of attention deficit/hyperactivity disorder in 5-6 year old children in Shiraz city. Studies in physical education and sports science. 2016;4(1):158-64. (Full Text in Persian)
41. Silva LAD, Doyenart R, Henrique Salvan P, Rodrigues W, Felipe Lopes J, Gomes K, et al. Swimming training improves mental health parameters, cognition and motor coordination in children with Attention Deficit Hyperactivity Disorder. International Journal of Environmental Health Research. 2020; 30(5):584-92.
42. Hattabi S, Bouallegue M, Jelleli H, Hammami N, Yahya HB, Bouden A. Effectiveness of a Recreational Swimming Program on Cognitive Functions of School-Children with Attention Deficit Hyperactivity Disorder (ADHD). Transylvanian Review. 2019;27(37). (Full Text in Persian)
43. Salehian MH, Golabchi M. The Effectiveness of Swimming Training on Reducing Coping Behaviors, Cognitive Problems and Inattention of Elementary School Hyperactive Girls. International Journal of Pediatrics. 2021; 9(11):14896-906. (Full Text in Persian)
44. Chen S-C, Yu BY-M, Suen LK-P, Yu J, Ho FY-Y, Yang J-J, et al. Massage therapy for the treatment of attention deficit/hyperactivity disorder (ADHD) in children and adolescents: a systematic review and meta-analysis. Complementary Therapies in Medicine. 2019; 99:389-42.
45. Asadi Z, Shakibaei F, Mazaheri M, Jafari-Mianaei S. The Effect of Foot Massage by Mother on the Severity of Attention-Deficit Hyperactivity Disorder Symptoms in Children Aged 6-12. Iran J Nurs Midwifery Res. 2020; 25(3):189-94. (Full Text in Persian)
46. Blasco-Fontecilla H, Moyano-Ramírez E, Méndez-González O, Rodrigo-Yanguas M, Martin-Moratinos M, Bella-Fernández M. Effectivity of Saffron Extract (Saffr'Activ) on Treatment for Children and Adolescents with Attention Deficit/Hyperactivity Disorder (ADHD): A Clinical Effectivity Study. Nutrients. 2022; 14(19).
47. Field T, Ironson G, Scafidi F, Nawrocki T, Goncalves A, Burman I, et al. Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations. International journal of neuroscience. 1996;86(3-4):197-205.
48. Field TM, Quintino O, Hernandez-Reif M, Koslovsky G. Adolescents with attention deficit hyperactivity disorder benefit from massage therapy. Adolescence. 1998;33(129):103.
49. Ibn-sina A. Al-Ghanun fi Al-teb. Lebanon: Al-Elmi Lel-Matbuat. 2025.
50. Khorasani A, Hussain SM. Kholase al-hekmat. Correction by professor Nazim Tehran First print. 2005;1. (Full Text in Persian)
51. Dadmehr M, Akhtari E, Haqiqi M. The effect of music on the improvement of sleep quality: a report from the viewpoint of Jorjani. Neurological Sciences. 2023;44(5):1787-9. (Full Text in Persian)
52. Lillehei AS, Halcon LL. A systematic review of the effect of inhaled essential oils on sleep. The Journal of Alternative and Complementary Medicine. 2014; 20(6):441-51.
53. Cheong MJ, Kim S, Kim JS, Lee H, Lyu Y-S, Lee YR, et al. A systematic literature review and meta-analysis of the clinical effects of aroma inhalation therapy on sleep problems. Medicine. 2021;1000(9).
54. Shahidi B, Khajenoori F, Najarzadegan MR, Mameneh M, Sheikh S, Babakhanian M, et al. A systematic review of the effectiveness of aromatherapy massage on sleep in children and infants. International Journal of Pediatrics. 2019;8(5):11233-41. (Full Text in Persian)
55. Godfrey H. Essential oils: Complementary treatment for attention deficit hyperactive disorder (ADHD). International Journal of Clinical Aromatherapy. 2009;6(1).
56. Naseri M, Jafari F, Alizadeh M. The Principles of Health Care and Sanitation in Traditional Medicine of Iran. Journal of Traditional Medicine of Iran and Islam. 2010;1(1):39-44. (Full Text in Persian)
57. Baziar S, Aqamolaei A, Khadem E, Mortazavi SH, Naderi S, Sahebolzamani E, et al. Crocus sativus L. versus methylphenidate in treatment of children with attention-deficit/hyperactivity disorder: A randomized, double-blind pilot study. Journal of child and adolescent psychopharmacology. 2019;29(3):205-12. (Full Text in Persian)
58. Ibn-e-Sina A. Al-Qānūn fī al-Tibb (Canon of Medicine). Beirut: Dare Ehyae al-Torathe al-Arabi. 2005.
59. Chashti M. Exir-e-Azam. Research Institute for Islamic and Complementary Medicine Tehran. 2008. (Full Text in Persian)
60. Khorasani SMA. Kholassat Al-Hekmah (the principal’s of traditional Iranian medicine). Qom: Esmaeilian; 2006. (Full Text in Persian)
61. Golsorkhi H, Kamalinejad M, Dadmehr M. The Useful Diet and Medicinal Plants for ADHD from the Viewpoint of Traditional Persian Medicine. International Journal of Pediatrics. 2022;10(3):15547-51. (Full Text in Persian)
62. Mostajeran Z, Mosavat SH, Najafi M, Emtiazy M, Hashempur MH. Whey protein (Ma’aljobon) as a complementary therapy for treatment of attention-deficit/hyperactivity disorder (ADHD): A randomized open-label controlled clinical trial. Galen Medical Journal. 2020;9:e1690. (Full Text in Persian)
63. McKeown C, Hisle-Gorman E, Eide M, Gorman GH, Nylund CM. Association of constipation and fecal incontinence with attention-deficit/hyperactivity disorder. Pediatrics. 2013;132(5):e1210-e5.
64. Zafari Z, Shokri S, Hasanvand A, Ahmadipour S, Anbari K. The Relationship Between Attention Deficit Hyperactivity Disorder and Functional Constipation in Patients Referred to Pediatric Gastrointestinal Clinic of the Hospitals of Khorramabad City, Iran. Crescent Journal of Medical & Biological Sciences. 2021;8(3). (Full Text in Persian)
65. Motaharifard M, Jafari Z, Paknejad MS, Oveidzadeh L, Karimi M. Prevention and treatment of constipation in children from the perspective of Iranian traditional medicine. Journal of Integrative Medicine. 2016;35:429-14.
66. Jorjani L. Zakhireh kharazmshahi. Bonyade Farhang Iran, Tehean;1992:101-74. (Full Text in Persian)
67. Nimrouzi M, Sadeghpour O, Imanieh M-H, Shams-Ardekani M, Zarshenas MM, Salehi A, et al. Remedies for children constipation in medieval Persia. Journal of evidence-based complementary & alternative medicine. 2014;19(2):137-43. (Full Text in Persian)
68. Nimrouzi M, Zarshenas MM. Functional constipation in children: non-pharmacological approach. J Integr Med. 2015;13(2):69-71. (Full Text in Persian)
69. Arzani MA. Mufarrih al Qulub (Sharh e Qanunche ye Jaghmini); Nazem E, Baghbani M, editors. Tehran: Al Ma‘i Publications; 2012. (Full Text in Persian)
70. Ahmadieh A. Rāz e Darmān. Tehran: Eqbal Publications; 1984. (Full Text in Persian)
71. Kazerani HR, editor The Laxative and Purgative Effects of Taranjabin. 19th Iranian Congress of Physiology and Pharmacology; 2009. (Full Text in Persian)
72. Mozaffarpur SA, Naseri M, Esmaeilidooki MR, Kamalinejad M, Bijani A. The effect of cassia fistula emulsion on pediatric functional constipation in comparison with mineral oil: a randomized, clinical trial. DARU Journal of Pharmaceutical Sciences. 2012;1:20-9. (Full Text in Persian)
73. Hajiarabi E, Khatibshahidi S, Motamed F, Farahmand F, Tansaz M. Comparison of Polyethylene Glycol 3350 and Product Made from Saccharum Officinarum L. for Treatment of Chronic Constipation; A Double-Blind Clinical Trial. The Journal of Alternative and Complementary Medicine. 2014; 20(5):A79-A. (Full Text in Persian)
74. Wahrburg U, Kratz M, Cullen P. Mediterranean diet, olive oil and health. European Journal of Lipid Science and Technology. 2002;104(9-10):698-705.
75. Kumar N, Kishore K. CHEMICAL AND HERBAL REMEDIES FOR CONSTIPATED PATIENTS: A. Indian Journal of drugs. 2013;1(2):23-37. (Full Text in Persian)
76. Wang X, Yin J. Complementary and alternative therapies for chronic constipation. Evidence-Based Complementary and Alternative Medicine;2015.
77. Kiluk BD, Weden S, Culotta VP. Sport participation and anxiety in children with ADHD. Journal of Attention Disorders. 2009;12(6):499-506.
78. Naderi F, Heidarie A, Bouron L, Asgari P. The efficacy of play therapy on ADHD, anxiety and social maturity in 8 to 12 years aged clientele children of Ahwaz metropolitan counseling clinics. Journal of applied sciences. 2010;10(3):189-95. (Full Text in Persian)
79. Zeinali S RR. The efficacy of sand therapy on hyperactivity and attention deficit in children. Rooyesh. 2020;9(5):127-34.
80. Haghtalab T, Yaghobi A, Asadbeigi S. Effectiveness Sand Tray Therapy on Hyperactivity Attention Deficit and Evident Anxiety of Children with Attention Deficit/ Hyperactivity Disorder. Empowering exceptional children. 2021;12(2):66-75. (Full Text in Persian)
81. Khilnani S, Field T, Hernandez-Reif M, Schanberg S. Massage therapy improves mood and behavior of students with attention-deficit/hyperactivity disorder. Adolescence (San Diego).2003;623-38.
82. Chevalaria C. Managing symptoms of attention deficit hyperactivity disorder (ADHD) with massage therapy in children and adolescents: a bibliographic review: Salut-UVic; 2022.
83. Dane S, Welcome MO. A case study: Effects of foot reflexotherapy on ADHD symptoms and enuresis nocturia in a child with ADHD and enuresis nocturia. Complementary Therapies in Clinical Practice. 2018;139:33-41.
84. Asadi Z, Shakibaei F, Mazaheri M, Jafari-Mianaei S. The effect of foot massage by mother on the severity of attention-deficit hyperactivity disorder symptoms in children aged 6–12. Iranian Journal of Nursing and Midwifery Research. 2020;25(3):189. (Full Text in Persian)
85. Subagya AN, Hartini S, Nurjannah I. Effect of foot reflexology on behavioral and emotional problems in preschool children. Enfermería Clínica. 2021;471:31-7.
86. Lange KW. The need for alternative treatments for attention-deficit/hyperactivity disorder. Movement and Nutrition in Health and Disease.2020;4.
87. Abd El Baaki OM, Abd El Hamid ER, Zaki ST, Alwakkad ASED, Sabry RN, Elsheikh EM. Diet modification impact on ADHD outcome. Bulletin of the National Research Centre.
88. Cagigal C, Silva T, Jesus M, Silva C. Does diet affect the symptoms of ADHD? Current pharmaceutical biotechnology. 2019;20(2):130-6.
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