Fig. 1

NYCKidSeq study design. The NYCKidSeq study involves two phases, a lead-in phase and a randomized controlled trial (RCT). Participants in both phases receive TGP and WGS testing and complete surveys at baseline, after result disclosure (ROR1 survey), and 6 months after result disclosure (ROR2 survey). In the lead-in phase, participants (N = 30) are enrolled into either the GUÍA feedback arm where participants complete a structured feedback interview after completion of the ROR1 survey or survey feedback arm where participants provide survey feedback after completing each survey. In the RCT phase, participants (N = 1100) are randomized to the GUÍA arm or the standard of care arm (SOC). Participants in the GUÍA arm receive result disclosure from genetic counselors using GUÍA versus participants in the SOC arm who receive SOC genetic counseling