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We surveyed 70 mobile app creators (34 professionals and 36 students learning mobile app creation) to understand their perceptions toward creativity and accessibility. We found mobile app creators who treated design constraints as creative constraints naturally included accessibility, but those with the freedom of unrestricted aesthetic design often disregarded accessibility. Our research suggests that we can change negative perceptions toward accessible design by making it an integrated part of the creative process. 

Mobile accessibility is often a property considered at the level of a single mobile application (app), but rarely on a larger scale of the entire app "ecosystem," such as all apps in an app store, their companies, developers, and user influences. We present a novel conceptual framework for the accessibility of mobile apps inspired by epidemiology. It considers apps within their ecosystems, over time, and at a population level. Under this metaphor, "inaccessibility" is a set of diseases that can be viewed through an epidemiological lens. Accordingly, our framework puts forth notions like risk and protective factors, prevalence, and health indicators found within a population of apps. This new framing offers terminology, motivation, and techniques to reframe how we approach and measure app accessibility. It establishes how app accessibility can benefit from multi-factor, longitudinal, and population-based analyses. Our epidemiology-inspired conceptual framework is the main contribution of this work, intended to provoke thought and inspire new work enhancing app accessibility at a systemic level. In a preliminary exercising of our framework, we perform an analysis of the prevalence of common determinants or accessibility barriers. We assess the health of a stratified sample of 100 popular Android apps using Google's Accessibility Scanner. We find that 100% of apps have at least one of nine accessibility errors and examine which errors are most common. A preliminary analysis of the frequency of co-occurrences of multiple errors in a single app is also presented. We find 72% of apps have five or six errors, suggesting an interaction among different errors or an underlying influence.