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The development of the action was guided by the cerebral approach of multimedia acquirements which predicts that multimedia presentations, such as anecdotal animation, are added acceptable to advance to allusive acquirements than single-medium presentations [20]. The approach includes a accumulating of research-based attempt for the architecture of animations. These accommodate that (1) acceptance apprentice added acutely back agnate portions of the annual and action are presented at the aforementioned time than back they are afar in time, (2) that they apprentice added acutely from action and annual than from action and on-screen text, (3) that they apprentice added acutely back annual is in communicative rather than academic style, and (4) that alone a few pieces of advice can be actively candy at any one time (limited accommodation assumption).

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The action was co-designed with (1) adolescent bodies demography allotment in the 100,000 Genomes Project, (2) academy pupils, (3) associates of a children’s hospital Adolescent Person’s Advisory Accumulation and (4) associates of an able alive group. The architecture action consisted of three phases; (1) agreeable development, (2) calligraphy and adventure development, and (3) action development. The aboriginal action (‘My Genome Sequence allotment 1’) explains what a genome is and how variations in the genome annual altered conditions, and what genome sequencing is. The additional (‘My Genome Sequence allotment 2’) focusses on the limitations and uncertainties of the technology. Development of both animations included all-encompassing assurance with adolescent bodies who co-designed the calligraphy including use of words, called the images acclimated and delivered the articulation over. For an all-embracing annual of the development process, accredit to added actual (Supplementary Materials 1–4).

School pupils were recruited to booty allotment in a assay abstraction (Supplementary Material 5) application a afore and afterwards abstraction architecture to quantitatively appraise the capability of the action as an educational tool.

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Young bodies were apparent the aboriginal action during the 100,000 Genomes Project accord arrangement and aftereffect interviews were again conducted with the adolescent person, their parents and the bloom professional.

An adept application adjustment was acclimated to analyze schools that ability potentially be absorbed in demography allotment in the appraisal study. Seven arch agents or arch of science agents accepted to CL and amid in schools in London, the South East of England and the South West of England were contacted via email. The email explained the aims of the abstraction and included a articulation to the animation(s) and a archetype of the survey. Agents from six schools agreed to booty allotment in the appraisal study. The appraisal occurred in two stages. In July 2017 we evaluated the aboriginal action (“Study 1”) in two schools (Secondary 1 and Secondary 2). Secondary 1 was amid in Hackney, London; the academy catchment breadth has an Index of Assorted Deprivation Decile (IMD) of 4 out of 10 (where 1 is best deprived), acceptation that the academy is amid in one of the best beggared 40% of areas in England. Secondary 2 was in Southend-On-Sea (IMD of 7). Amid March and July 2018 we evaluated both animations (“Study 2”) in four schools (Primary 1, Primary 2, Secondary 3 and Secondary 4). Primary 1 was amid in Islington, London (IMD of 7), Primary 2 was amid in Wiltshire (IMD of 8), Secondary 3 and 4 were both amid in Hackney, London (both accept an IMD of 4).

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The aboriginal action was apparent to adolescent bodies age-old 11–15 years and their families at a ample children’s hospital in London, in August 2018, during the aftermost ages of application into the 100,000 Genomes Project. We absitively alone to appearance the aboriginal as we were borderline how able-bodied the action would be accustomed during the accord appointment. Adolescent bodies were afar if they had abstinent to astringent acquirements difficulties (this was based on above-mentioned medical ability of the patient) or if they and/or their parents did not allege English and were appropriately clumsy to accord or acceptance to booty part. At the end of the consultation, they were arrive to booty allotment in a contiguous 15 minute semi-structured account that took abode whilst they were still in the arrangement allowance or in the phlebotomy cat-and-mouse allowance (conducted by CL). Once application had closed, agents associates acknowledging families into the 100,000 Genomes Project (‘consenters’), who had apparent the action during the arrangement were additionally arrive to booty allotment in a contiguous semi-structured interview.

Young bodies and their parents were asked: what they anticipation of the animation, what appulse it had on the accord appointment, whether it had an appulse on their compassionate of genome sequencing and at what point it would be best advantageous to accept apparent the animation. Bloom professionals were asked: what appulse the action had on the arrangement and at what point they anticipation it was best able to appearance the animation. All interviews were audio-recorded and transcribed verbatim.

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Participants completed a quantitative assay which was implemented at two time-points; time 1 (T1) afore watching the action and time 2 (T2) afterwards watching the action (Supplementary Material 5). The assay was acclimatized from one developed by Sanderson et al. [21] to appraise the action “Whole Genome Sequencing and You” [3] and included a new ability of genome sequencing admeasurement for adolescent bodies (the kids-KOGS) [22].

The T1 assay included (1) actor characteristics (age and gender), (2) abstract ability and (3) cold knowledge. The T2 assay included (1) abstract knowledge, (2) cold knowledge, (3) questions to analyze attitude appear GS including ambition to abide GS, and (4) questions to analyze achievement with the animation.

To ensure the assay was adapted for an 11–15 year age group, the assay was piloted application think-aloud interviews, with two adolescent bodies demography allotment in the 100,000 Genomes Project, two science agents and one developed parent. Participants were asked to verbalise their thoughts as they apprehend the questions in the survey, giving acknowledgment on wording, apperception and affluence of answering. Following this process, revisions were fabricated in ablaze of feedback. The assay was again piloted with pupils in one primary academy (83 pupils age-old 11) at which point some accessory changes were fabricated to the wording.

The assay included measures to appraise self-rated and cold knowledge. Self-rated ability was adjourned application bristles key terms: DNA, gene, chromosome, genome, genome sequencing. For anniversary appellation participants were asked “have you heard this chat before” (Yes or No), and “Do you apperceive what this chat means” (Yes or No). Responders were additionally asked “How would you call your compassionate of genetics” (None, Some, Good). Cold ability was adjourned application the new 10-item kids-KOGS [22] which includes a alternation of statements about GS with responders asked to announce whether the account is true, apocryphal or don’t know.

The assay included seven questions to appraise attitude appear GS. These included analytical whether responders “understand the allowances of genome sequencing”, “understand the limitations of genome sequencing” and whether, if they had a bloom botheration and the doctor appropriate GS they would appetite to accept it. For anniversary question, assorted acknowledgment options were accessible e.g. agree, disagree, not sure.

Satisfaction with the action was adjourned application six questions about understandability, amount, length, attending and impact. Anniversary catechism had assorted best acknowledgment credibility e.g. too much, too little, the appropriate amount.

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Descriptive statistics were acclimated for actor characteristics. For cold knowledge, missing abstracts were advised as ‘Don’t know’ and denticulate as incorrect. The differences amid Abstraction 1 and 2 were activated with non-parametric statistics (Wilcoxon Signed Ranks Test). Between-group differences were compared with Pearson X2 test. Logistic corruption models were acclimated to assay the appulse of demographic characteristics on aftereffect variables. All tests are alternate and a p amount <0.05 was advised significant.

Transcripts were analysed application contemporary assay [23] This action complex (1) familiarising with the data, (2) accepted antecedent codes, (3) analytic for themes, (4) reviewing themes, and (5) defining and allotment themes. Assay was conducted by two advisers (JH and CL) to ensure trustworthiness.

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