ehp volume 17 issue 6 ehps.net/ehp The European Health Psychologist Health literacy (HL) refers to the ability to acquire, assimilate, and apply health-related information in ways that are appropriate for one’s health (Lai, Ishikawa, Kiuchi, Mooppil, & Griva, 2013). The increasing interest in and promine- nce of HL research are reflected by the growth in published peer reviewed articles, from under 300 peer reviewed publications in the 1990s to several thousand by 2015 (Nutbeam, 2015; Rudd, Anderson, Oppenheimer, & Nath, 2007; Rudd, Anderson, Oppenheimer, Rosenfeld, & Mandic, 2007). In the early stages of HL studies, researchers focused most of their attention on the literacy skills and deficits of individuals and the association between measured skills and a variety of health outcomes. As a result, numerous tools have been developed and validated to assess patients’ HL levels (Haun, Valerio, McCormack, Sørensen, & Paasche-Orlow, 2014), forming the basis of research aimed to explore the links between literacy skills and health outcomes. We now have strong evidence of the associations between low levels of HL and a myriad of negative health outcomes, including increased use of emergency care, lower use of preventive health services, poorer treatment adherence, likelihood of tobacco use, lessened ability to manage chronic disease, and higher rates of hospitalization, depression, and mortality (Berkman, Sheridan, Donahue, Halpern, & Crotty, 2011; DeWalt, Berkman, Sheridan, Lohr, & Pignone, 2004). However, HL research needs to continue to build on the knowledge we have accumulated in order to bring about efficacious change. Despite the evidence provided by over 1,500 articles (in English) establishing a mismatch between skills of the public and complexity of health infor- mation being provided (Rudd, 2014; Rowlands et al., 2015), calls for examining the communication skills of health professionals and the literacy related barriers in healthcare are only now starting to be heeded (Koh & Rudd, 2015). Advancing HL from an individual focus to a system perspective is challenging, in part, because the majority of research has dispro- portionately focused on the patient, such as measurement of patient HL levels without the concordant measurement of clinical commu- nication or complexity of materials and tools. The key to advancing HL research is to expand the scope of inquiry and action to include the communication abilities of all health profe- ssionals and staff who interact with the patients, individuals, and communities to ensure the appropriateness and accessibility of health- related information, and collectively build a care environment and culture that effectively inte- grates HL in its activities (Rudd, 2015). In this paper, we briefly review several articles that can shed insight on needed action along with a brief description of a HL training program conducted in Japan. Specifically, we highlight an adaptation of the "Eliminating Barriers- Increasing Access Workshop" developed in the US and modified for a series of HL training for Advancing health literacy from a system perspective: Health literacy training for healthcare professionals HL training for healthcare professionals Lai et al. Alden Yuanhong Lai Johns Hopkins Bloomberg School of Public Health Aya Goto Fukushima Medical University Rima Rudd Harvard T.H. Chan School of Public Health