OBJECTIVE:: To evaluate the direct and interacting effects of personal and systemic factors that contribute to psychological distress among frontline healthcare workers (FHCWs) during the COVID-19 pandemic. METHODS:: Data were collected using a hospital-wide, cross-sectional survey. A multivariable binary logistic regression and relative importance analysis was conducted to identify factors associated with screening positive for C19-distress. RESULTS:: A total of 1,005 (39.0%, 95%CI = 37.1–40.9%) out of 2,579 FHCWs met the pre-specified cutoff values for significant symptoms of C19-distress. Fewer sleep hours and lower perceptions of leadership support explained the majority of variance (19.4% relative variance explained [RVE]) in C19-distress, followed by team camaraderie (6.4% RVE), physical exercise (4.9% RVE), and engagement in hobbies (3.2% RVE). CONCLUSION:: These results underscore the importance of restorative behaviors as potential targets to help decrease distress and promote resilience in FHCWs.