In Part II paper (American Journal of Addictions, Vol 26, pages 67-74, this issue), we address how this literature informs a research program meant to develop and evaluate and stigma strategies (eg, education, contact, and protest). Both papers end with recommendations for next steps to jumpstart the addiction stigma portfolio. Here in Part I, we offer one possible list of key research issues for studies attempting to describe or explain addiction stigma. (Am J Addict 2017;26:59-66).

African Americans with mental illness who are homeless experience significant health risks and illnesses leading to high mortality and morbidity rates. A community-based participatory research (CBPR) team conducted a qualitative study to begin to describe these problems. Results from focus groups and key informant interviews of 42 individuals yielded 98 themes which were sorted into three categories: problems, solutions, and peer navigators. Results included a review of the problems and solutions which the community or people might adopt. An additional goal was to understand and develop impact of peer navigators for addressing health problems in this group. Results yielded a list of values in hiring peer navigators as well as skills and resources they might need to successfully do their job. Findings from the study are currently being used by the CBPR team to develop a peer navigator program for this community.

Objective Impact of a peer navigator program (PNP) develop by a community based participatory research team was examined on African Americans with serious mental illness who were homeless. Methods Research participants were randomized to PNP or a treatment-as-usual control group for one year. Data on physical and mental health, recovery, and quality of life were collected at baseline, 4, 8 and 12 months. Results Findings from group by trial ANOVAs of omnibus measures of the four constructs showed significant impact over the one year for participants in PNP compared to control described by small to moderate effect sizes. These differences emerged even though both groups showed significant improvements in reduced homelessness and insurance coverage. Conclusions Implications for improving in-the-field health care for this population are discussed. Whether these results occurred because navigators were peers per se needs to be examined in future research.