Hello John,
About your first question, with App Builder we can develop "fixed" and "auto scaled" apps. The first ones do not scale automatically, then, if we design the app in one determined size (800x600, for example) that's the fixed size of the app and therefore requires an screen capable to deal with that app's size. If we develop an desktop app that don't need a mobile version, the "fixed" size can be good. But continue reading...
On the other hand, "auto scaled" apps try to adapt the app interface into all the screen sizes. This mean that we can design with an 320x480 size (this is the default and recommended size) and our app can scale automatically to larger screens. Note that we can not do the opposite: we can't design our app with an 360x640 size and then view the app in an 320x480 size. This don't work as expected.
App Builder includes in our apps the two possible styles: "fixed" and "autoscaled", and, we can change between these styles in runtime too, using the "SetAppScaled" action. Even more, we can set the app to a determined size, but continue using the "autoscale" style instead of the "fixed" one. An example of this can be the Calculator app sample. This sample set the size to 800x600 in larger screens, but continue using the "autoscaled" style.
Depending on the app and their deploy requirements we can design the app in one size or another. Generally, if we want that our app works in almost all screens, we must use the default 320x480 size and the "autoscaled" style. The only problem with this can be when very larger (from our 320x480 point of view) appear in the scene, but, we can simply let the app to scale, or do what the Calculator sample app does: limit their max size to 800x600 autoscaling the controls to that size.
Additionally, note that we can also act in runtime to change the controls sizes, positions, etc. But this is probably not required in the most cases: maybe is not a good idea to perform interface changes depending on the screen sizes, devices, etc. The best is to design our apps to fit our needs (again, 320x480 is a good start point) and let the styles to do their work. Maybe limit the app size for larger screens, but don't do too much more.
Please, John, take a look at these App Builder's app samples: "Calculator", "Scaled" and "InputScroll2".
About your second question, the term "accesibility" can be quite extense. If we are thinking in people who must use, for example, some assistive technology like an screen reader, certainly almost all App Builder's controls have an "AriaLabel" variable, which determines some content useful for that users. On the other hand, if you wanted is to change the font sizes, colors, etc., the action "SetStyle" is for you. But, in principle, we no need to do nothing special with font, font's sizes, etc.
Please, go ahead if you have any further questions John.
P.S. A possible question when design our apps from an 320x480 size, for example, can be, how I can place several controls in the app's views? And the answer is, of course: you can't place several controls in smaller screens! However, this have at least two solutions. The first one is go ahead the view's height. Certainly we can place controls beyond the app's view height, and this work as expected: the app view's can be "scrolled" by the user to reach the controls.
Another possible solution for the above question is to use various app's views. There is no limit in the number of app's views that we can use. Then, supose, for example, we are preparing an user profile edit form. We can add several controls in a view (beyond their original height), but we can also prepare an view with an profile's sections Menu. Then, every Menu item give the user access to other specific app's views, so we can have a view to edit the profile's user information, another view to edit the profile's user app options, etc., etc.