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Table 3 Key themes and sub-themes from respondent narratives

From: Meso level influences on long term condition self-management: stakeholder accounts of commonalities and differences across six European countries

  BG GR SP UK NO NL
Social environmental influences on diabetes self-management + + + + + +
Social inequalities impact on resources for SM     + + +
Public stigma and impact of portrayal of behavioural dispositions + +   + +  
Media and the portrayal of stigma + + + + +  
Diabetogenic food environment + +   + +  
Inability of policy to regulate processes and environments related to chronic illness management + + + + + +
Lack of governments capacity to regulate the food supply chain +    + +  
Growing responsibility of localities stakeholders in a context of financial uncertainty    + + + +
Challenges associated with the coordination, funding, and implementation of local commissioning of services     + + +
Extending the scope of voluntary and community groups and private provider involvement in SMS     + +  
Few welfare resources and impact of austerity on local supply and demand for SMS + +   +   
Bio-medical tendencies and incentives in primary care + + + + + +
Gap between SMS policy and implementation within health services + + + + +  
Inconsistent support for shift in healthcare provision towards better SMS   + + +   
Prevention/ public health interventions have a role in SMS + + + + + +
Insufficient policy level commitment to implementing SMS policies + + + + +  
Lack of incentives for SMS   +   +   
Insufficient SMS tools and infrastructure in the health service + + + + + +
Drugs companies interests as barrier to implementing SMS + + + + +  
Professionals interests as barrier to implementing SMS +   + +   
Growing involvement of patient groups    +   + +
Financial crisis as an opportunity for changes in the healthcare system   + + +   
System level crisis as a dominant policy concern + +     
Drug companies providing SMS in the absence of state capacity + + +