On a recent trip to Ireland, my Penn State University colleagues Mark Greenberg and Brian Bumbarger and I had the opportunity to visit collaborators in Belfast and Dublin. The purpose was to hold problem-solving discussions about some of the challenges and issues that the prevention efforts are facing in Ireland.

In our first session, we were talking about randomized controlled trials (RCTs) and alternative ways one can design them to work, given all the complex issues of doing applied research. One person from the Belfast site expressed her intense feeling of needing assistance by saying, “Take me by the elbow, please!” The metaphor caused a good amount of laughter all round.

Nevertheless, the statement rings true because the work of implementing evidence-based programs and conducting RCTs to measure their effectiveness in the real world is very difficult indeed. In order to engage in this type of work within the “real world” practitioners and researchers must acknowledge the need each will have to be led by the hand – or sometimes by the elbow.

We believe that there is a real opportunity for all the practitioners and researchers involved to engage in co-learning. The very nature of the effort suggests that the learning and advances will be iterative.

Our experience of conducting similar efforts in the US has taught us the importance of establishing structure and ongoing opportunities for lesson-learned sharing. These efforts will build capacity among practitioners and researchers in different communities. Learning communities are one example of an effective process for capturing and sharing the accumulated knowledge practitioners and researcher gain in the process of taking part in a comprehensive prevention initiative. This model further empowers a peer support network and encourages the development of field-initiated expertise.

I believe that the willingness of everyone involved in the Irish effort to be led – and to lead – by the elbow will help advance the field of prevention science further and, more importantly, increase the likelihood of success.