Asthma is a chronic respiratory disease that affects millions of people around the world. It is estimated that approximately 300 million people were affected globally, and causing around 1000 deaths per day (Global Initiative for Asthma, 2024). In Brazil, there are approximately 20 million individuals with the disease, accounting for approximately 350,000 annual hospitalizations (Cardoso et al., 2017). The prevalence of asthma, however, varies according to geographic location, climate, lifestyle and region level of economic development (Global Initiative for Asthma, 2024). In terms of age groups, the disease is more common among children and adolescents, with a particularly high prevalence in this group. It is estimated that around 20 % of Brazilian children suffer from asthma (Cardoso et al., 2017), reflecting a global trend, where the prevalence of asthma is higher among adolescents, with 11.0 % of young people presenting current symptoms of the disease, followed by 9.1 % of children and 6.6 % of adults (Global Initiative for Asthma, 2024).

Considered a heterogeneous, obstructive, and chronic disease, asthma is associated with genetic and environmental factors. Its main characteristic is airway inflammation, which, when exposed to triggering factors, become hyperreactive or obstructed. This results in restricted airflow due to bronchoconstriction, excessive mucus production, and increased inflammation (Global Initiative for Asthma, 2024). As airway inflammation progresses, symptoms of coughing, wheezing, rapid and shallow breathing, and a feeling of tightness in the chest increase, which can vary in intensity depending on expiratory flow variation. The main external factors associated with the development of asthma attacks are viral infections, exposure to mites, fungi, pollen, smoke, exercise, emotions, and chemical irritants (Peters et al., 2019).

The impact of asthma goes beyond the simple presence of respiratory symptoms. The disease, when poorly controlled, can significantly interfere with patients' quality of life, especially among children and adolescents. Studies have shown that between one third and one half of children and adolescents with asthma symptoms have a severe form of the disease, which includes frequent episodes of shortness of breath and coughing, limitations in daily activities and sleep interrupted by asthmatic symptoms (Global Initiative for Asthma, 2024). These severe symptoms are associated with a higher rate of school absenteeism, reduced participation in physical and recreational activities and, consequently, a negative impact on the social and emotional development of affected young people.

The appropriate approach to children with asthma, aiming at controlling the disease, is essential to improve quality of life, minimize the risk of decreased lung function over time and prevent deaths. To this end, it is necessary for the health team to carry out an individualized approach, including health education regarding pharmacological and non-pharmacological treatment for patients and their families (Chong Neto et al., 2018).

Studies indicate that the difficulty in controlling asthma is mainly related to: environmental factors; failures in the inhalation technique; low adherence rate to treatment, which occur due to a lack of understanding of treatment objectives and the severity of the disease; fear related to the side effects of medications; psychological factors; complexity of therapeutic regimen; difficulties associated with routes of administration, especially inhalation; and failure in family control when caring for children (Giubergia et al., 2018; Bonini, 2017; Han et al., 2020).

In this context, the relevance of health education is evident, a practice used to train people so that, through access to information, they can implement assertive actions and stay healthy. Nurses who work in the care of children with asthma need to optimize prevention, through educational guidance, training family members and children about the disease, the care and actions necessary to control it, using strategies and tools such as health education technologies, which play a crucial role not only in supporting professionals, but also in training patients in new skills and improving existing ones. They facilitate the connection between the learning process and its practical application, using a variety of methods such as educational techniques (de Carvalho et al., 2021; Lima et al., 2021; Lima et al., 2021; Lima et al., 2022; Vasconcelos et al., 2023).

The expansion of the use of health education technologies is occurring due to their ability to make topics more engaging, encouraging user engagement and interest (Lima et al., 2021). This resource facilitates the health learning process, while contributing to the construction of skills that promote knowledge about care and self-care (Hermes et al., 2021). Educational technologies can be suitable tools for, through learning, turning children into agents of knowledge, since they favor the participation of subjects in the educational process, increasing the autonomy of those involved (Pedrinho et al., 2021).

Regarding children with asthma, the strategy of providing patients with written and illustrated educational material, with information about treatment, correct use of the inhalation technique, recognition of asthma attacks and control of attacks, with reinforcement of verbal guidance given by healthcare professionals, enables better understanding and can promote improved adherence, considering that it is possible to refer to the printed material when doubts arise (Frota et al., 2020).

Among the various printed educational strategies, comic books not only provide entertainment, but also promote discussions in various areas. In healthcare, they have been used to illustrate narratives about diseases, in addition to serving as a tool for learning about health conditions, emotions, and environmental experiences. The combination of text and images can increase the effectiveness of teaching by activating different information processing pathways in the brain (Frota et al., 2020; Mendelson et al., 2017).

Tools such as play and storytelling are effective in informing children about health-related topics, thereby encouraging participation in their own care (Januário et al., 2021). Comic books, in particular, offer simple language and brief texts complemented by illustrations, presenting information in a child-friendly and engaging manner (Silva et al., 2024). This format can influence decision-making and reshape perceptions about illness (Alemany-Pagès et al., 2022). In Brazil, a study involving 47 children aged 6 to 12 demonstrated that a comic book on oral health significantly improved hygiene habits—daily tooth brushing increased by 25.53 %, flossing by 55.32 %, and independent hygiene practices by 17.03 % (Silva et al., 2022).

Similarly, in a Pediatric Intensive Care Unit, the use of a comic book tailored to hospitalized children enabled active participation in care, enhanced communication, and promoted emotional expression, highlighting its value as a playful-educational strategy in complex clinical settings (Sousa & Brondani, 2023).

Considering asthma as a public health concern with high morbidity and mortality in the pediatric population and the need to use strategies that favor communication with children, this study aimed to develop and analyze evidence of validity of a comic book for self-care of children with asthma.