Table 3 Code structures

Facilitators to the intervention implementation

● Perceived benefits on children and parents

● Benefits on children’s health, mainly on sleep and appetite

● Benefits on children’s emption

● Benefits on children’s learning abilities

● Benefits on parents’ moods

● Benefits on parent–child relationship

● Acceptability of children and parents

● Parents’ acceptability (e.g., safety, convenience, feasible home setting, economic issues)

● Children’s acceptability (e.g., enjoy massage, intimacy with parents)

● Professional supports

● TCM PI, training course, comprehensive guidance, teaching videos and books, regular information sharing

● Parents’ expectations on long-term effects of the intervention

● Parents’ expectations on improving children’s ADHD symptoms and constitutes in a long term via the intervention

Barriers to the intervention implementation

● Limited benefits on children’s inattention symptoms

● Slow and inconspicuous effects on children’s inattention symptom

● Manipulation management difficulties

● Parents’ uncertainties of the manipulation techniques (e.g., strength, prescription)

● Delayed onset effects of pediatric tuina conducted by parents

● Limitations of TCM pattern identification

● Limitations of online TCM PI (e.g., inspection might be inaccurate; palpation was not available)