Infrastructure for open, distance, and digital education (ODDE) needs to have the capability to dynamically develop to accommodate varying models for the delivery of the curriculum and the changing needs of students and institutions. The capability to dynamically develop can be instilled within the institutional infrastructure for ODDE which includes areas such as information technology (IT), emerging technologies, marketing and recruitment, student prospect lead management, registration, educational materials, libraries, and student supports. Organizationally, infrastructures to support affordability, scalability, sustainability, and support must be developed. Open questions and directions for future research on institutional infrastructure for ODDE along with implications for ODDE practice that arise from this research are included.

Infrastructure for open, distance, and digital education (ODDE) needs to have the capability to dynamically develop to accommodate varying models for the delivery of the curriculum and the changing needs of students and institutions. The capability to dynamically develop can be instilled within the institutional infrastructure for ODDE which includes areas such as information technology (IT), emerging technologies, marketing and recruitment, student prospect lead management, registration, educational materials, libraries, and student supports. Organizationally, infrastructures to support affordability, scalability, sustainability, and support must be developed. Open questions and directions for future research on institutional infrastructure for ODDE along with implications for ODDE practice that arise from this research are included.

People with intellectual and developmental disabilities (PWIDD) face persistent inequalities in accessing inclusive and health education. This contributes to lower participation in cancer screening, limited access to tailored health information, and poorer health outcomes. This study aimed to develop and evaluate a co-produced, pan-European COST Action CUPID Training School applying Universal Design for Learning (UDL) to improve cancer prevention education and health literacy for PWIDD. Co-produced, pan-European training intervention. A cross-European Training School was collaboratively developed by researchers, health professionals, educators, and PWIDD. UDL principles guided its design to ensure flexibility, accessibility, and inclusivity. A framework comprising six principles informed the approach: health literacy through tailored resources; inclusion of PWIDD as equal participants; co-production in shaping content and delivery; accessibility through easy-read, multimedia, and plain language formats; scaffolding to support confidence and comprehension; and cultural adaptation to different national contexts. The Training School demonstrated that inclusive education, UDL, and participatory approaches can be applied effectively across international and cultural contexts. PWIDD contributed as both co-trainers and learners, enhancing relevance and accessibility. Participants reported increased awareness of inclusive practices, improved understanding of cancer prevention, and strengthened communication skills. A co-produced, UDL-informed framework centred on inclusion, co-production, health literacy, accessibility, scaffolding, and cultural adaptation offers a promising approach to advancing health literacy for PWIDD. Embedding these principles within mainstream health prevention and inclusive education strategies, alongside addressing systemic barriers, is essential for achieving sustained improvements in health equity.